Supervisor, Provider Enrollment

Ventra Health, Inc.; Northern (KY); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Discretionary incentive bonus

Job summary

Ventra Health is seeking a Supervisor, Provider Enrollment to lead the day-to-day activities of the Provider Enrollment Department. You will supervise staff, develop performance standards, and ensure compliance with state and federal regulations governing provider enrollment.

You will train staff, perform audits, coordinate with the Provider Enrollment Manager, and drive timely Medicare provider enrollment, revalidations, and payer interactions.

Qualifications

• High school diploma or equivalent required; college degree preferred.
• Two (2) years’ supervisory experience.
• Two (2) years’ experience in Provider Enrollment.
• Knowledge of NCQA standards related to provider enrollment and health plan enrollment.

Responsibilities

• Supervise, train, and support provider enrollment staff responsible for licensing, enrollment, privileging, and maintenance of credentials.
• Coordinate with Provider Enrollment Manager on employee relations duties.
• Review, edit, and process employee timecards and schedules.
• Assist with annual performance reviews for provider enrollment staff.
• Monitor Medicare revalidations for all providers.
• Research enrollment denials with AR; resolve rejections with Clean Claims.

Skills

Verbal and written communication

Microsoft Office Suite

Independent judgment

Multi-tasking

Organizational skills

Education

High school diploma or equivalent

College degree preferred

Tools

Proprietary database applications

Job description

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Come Join Our Team!

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus!

Job Summary

• The Supervisor, Provider Enrollment is responsible for assisting with the day-to-day activities of the Provider Enrollment Department, act as the first line leader to staff, and contributes to the development of processes and procedures. Monitor the quantity and accuracy of activities performed by subordinate staff. Development of work plans, develop and maintain performance standards associated with various functions. Expert knowledge and independent application of state and federal regulations governing healthcare. A high degree of applied knowledge of provider enrollment nuances. Staff training and assisting staff to resolve complex provider enrollment issues. Perform deep-dive audits of specific accounts, payers, or the work performed by an individual. Draft processes and procedures consistent with applicable regulations and/or specific payers. Interpretation of complex regulations and department procedural billing policies; and supervisor of subordinate staff.

Essential Functions and Tasks

• Supervise, train, and support provider enrollment staff responsible for licensing, provider enrollment, privileging, enrollment, reappointments and/or maintenance of professional credentials.
• Work with Provider Enrollment Manager to complete employee relation duties as necessary such as coaching, mentoring, corrective action, or similar.
• Review, edit, and process employee timecards, and schedules.
• Assist with or prepare annual performance reviews for provider enrollment staff.
• Send Medicare Revalidation reminders for all providers.
• Monitor held claims in AIMs/Work release emails for held claims.
• Conduct client calls to provide status updates on clients.
• Work with AR to research provider enrollment related denials.
• Work with Clean Claims to research provider enrollment related rejections.
• Ensure any questions regarding releases are answered in a timely fashion.
• Responsible for ensuring Medicare provider enrollment items are completed timely.
• Work with Client Management to provide support on client concerns and updates.
• Enrollment for special projects and provide additional support as needed.
• Meet staff for one-on-one touch base on performance/feedback concerns.
• Work with Payments for requested EFT enrollments/updates.
• Develop, maintain, and track various performance measures.
• Prepare status reports and perform special projects as required.
• Performs other related job duties as assigned.

Education and Experience Requirements

• High school diploma or equivalent required, college degree preferred.
• Two (2) years’ experience in supervision.
• Two (2) years’ experience in Provider Enrollment.
• Knowledge of NCQA standards as it relates to provider enrollment and health plan enrollment.

Knowledge, Skills, and Abilities

• Excellent verbal and written communication skills.
• Proficient in Microsoft Office Suite and proprietary database applications.
• Ability to use independent judgment and to manage and impart confidential information.
• Ability to multi-task, manage priorities and meet critical deadlines.
• Ability to work independently and in a fast-paced environment.
• High level of awareness of pertinent details; excellent organizational skills.

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.

• This position is also eligible for a discretionary incentive bonus in accordance with company policies.

Ventra Health

Equal Employment Opportunity (Applicable only in the US) Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.Recruitment AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement.

Statement of AccessibilityVentra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.