Director, Provider Enrollment

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead and oversee the daily operations of the Provider Enrollment department.

• Recruit, select, onboard, train, mentor, counsel, and discipline team members.

• Build relationships with Provider Enrollment teams to document organizational priorities and needs.

• Supervise the provider enrollment lifecycle, which includes new enrollments, re-enrollments, enrollment denials, and client-specific special projects.

• Track client-level metrics, ensuring that enrollment activities are timely and accurate.

• Cultivate client relationships and provide consistent updates on credentialing deliverables.

• Suggest workflow enhancements throughout the enrollment process.

• Create and endorse policies and guidelines, implementing procedures for uniform compliance across the department.

• Conduct management meetings to discuss held claims, client provider enrollment status, and the provider enrollment inventory.

• Monitor departmental activities, identify inefficiencies, and establish processes to enhance timeliness and effectiveness.

• Compile and generate management reports to analyze trends and provide recommendations.

• Undertake special projects and fulfill additional assigned responsibilities.

⛳️ Requirements

• High School diploma or equivalent is required.

• A minimum of five (5) years of experience in physician billing, hospital billing, or vendor management within provider enrollment functions.

• Familiarity with provider enrollment requirements for physician billing, with multi-state experience preferred.

• Understanding of business and financial processes and procedures.

• Knowledge of medical terminology and anatomy.

• Awareness of medical record documentation standards.

• Strong supervisory and management capabilities.

• Excellent leadership development and team-building abilities.

• Proficient in management-level oral, written, and interpersonal communication.

• Strong skills in financial reporting.

• Proficient in healthcare data analysis.

• Competent in developing and delivering presentations.

• Strong skills in word processing, spreadsheets, databases, and presentation software.

• Excellent decision-making, problem-solving, organizational, time management, and mathematical abilities.

• Capacity to present financial reports and healthcare analytics to executives, managers, clients, and customers.

• Ability to adjust communication styles to diverse audiences.

• Proficiency in professionally communicating with business stakeholders and IT personnel.

• Ability to identify and resolve recurring issues proactively.

• Preferred: At least two (2) years of supervisory, management, or leadership experience.

• Preferred: Experience with CAQH database, NPI website, and maintaining EDI, EFT, and ERA processes.

🏝️ Benefits

• Ventra performance-based incentive plan.

• Discretionary incentive bonus in line with company policies.

• Referral bonus.

• Reasonable accommodations for qualified individuals with disabilities.