Provider Enrollment Specialist

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

📋 Description

• Collaborates with the Provider Enrollment Manager to identify and address Provider Payer Enrollment issues or denials.

• Investigates, resolves, and facilitates enrollment of any payer-related concerns, using a range of proprietary and external tools.

• Communicates with clients, operations staff, and the Centers for Medicare & Medicaid Services (CMS) through phone, email, or their website.

• Conducts follow-ups with market locations to investigate and resolve payer enrollment challenges.

• Oversees the completion and submission of applications for CMS Medicare, State Medicaid, and other third-party payers.

• Keeps thorough documentation and reporting concerning ongoing payer enrollments.

• Fosters strong working relationships with Clients, Operations, and the Revenue Cycle Management team.

⛳️ Requirements

• An Associate's degree (2 years) is required.

• A Bachelor's degree in a related field is preferred.

• At least one (1) year of experience in provider enrollment is preferred.

• Familiarity with specific application requirements for the Centers for Medicare & Medicaid Services (CMS), State Medicaid, and all third-party payers.

• Understanding of physician HIPAA Privacy & Security policies and procedures.

• Proficient in word processing, spreadsheet, database, and presentation software.

• Capable of ensuring that complex enrollment packages are complete and accurate.

• Ability to work autonomously with minimal supervision, focusing on and achieving tasks.

• Committed to maintaining strict confidentiality regarding protected provider and health information.

🏝️ Benefits

• Ventra performance-based incentive plan.

• Referral bonus.