Provider Enrollment Specialist: Payer & CMS Expert

Ventra Health, Inc.; Clark, Northern (NJ, KY); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Rewards & Recognition program

Referral bonus

Incentive plan

Job summary

Ventra Health is seeking a Provider Enrollment Specialist to support the enrollment process by researching payer issues, resolving CMS-related denials, and coordinating with clients and operations. You will manage enrollment applications and ensure provider numbers are linked to the correct client groups.

The role requires an associate degree and ideally 1+ year of enrollment experience. Candidates should be detail-oriented, analytical, and capable of working in a team to meet strict deadlines

Qualifications

• Working knowledge of CMS, State Medicaid, and third-party payers
• Knowledge of HIPAA/privacy policies
• Strong written, verbal, and interpersonal communication skills
• Excellent attention to detail and organizational abilities

Responsibilities

• Research and resolve payer enrollment issues with providers and market locations
• Communicate with CMS and payers via phone, email, or websites
• Prepare and submit CMS Medicare and State Medicaid enrollment applications
• Maintain provider demographics and enrollment status across systems
• Document enrollment progress and maintain records of completed applications

Skills

CMS enrollment knowledge

HIPAA privacy & security

Clear communication

Attention to detail

Analytical skills

Organizational skills

Teamwork

Education

Associate's degree (2 years)

Bachelor's degree in related field

Job description

Ventra Health is seeking a Provider Enrollment Specialist to support the enrollment process by researching payer issues, resolving CMS-related denials, and coordinating with clients and operations. You will manage enrollment applications and ensure provider numbers are linked to the correct client groups.

The role requires an associate degree and ideally 1+ year of enrollment experience. Candidates should be detail-oriented, analytical, and capable of working in a team to meet strict deadlines