Provider Enrollment Specialist

• Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, 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.

• The Provider Enrollment Specialist works in conjunction with the Provider Enrollment Manager to identify Provider Payer Enrollment issues or denials.  This position is responsible for researching, resolving, and enrolling any payer issues, utilizing a variety of proprietary and external tools.  This will require contacting clients, operations personnel, and Centers for Medicare & Medicaid Services (CMS) via phone, email, or website

• Performs follow-up with market locations to research and resolve payer enrollment issues
• Performs follow-up with Centers for Medicare & Medicaid Services (CMS), and other payer via phone, email or website to resolve any Payer Enrollment issues
• Manages the completion and submission of CMS Medicare, State Medicaid and any other third-party payer applications
• Performs tracking and follow-up to ensure provider numbers are established and linked to the appropriate client group entity and proper software systems
• Maintains documentation and reporting regarding payer enrollments in process.
• Retains records related to completed CMS applications
• Establishes close working relationships with Clients, Operations, and Revenue Cycle Management team
• Proactively obtains, tracks, and manages all payer revalidation dates for all assigned groups/providers as well as complete, submit, and track the required applications to maintain active enrollment and prevent deactivation
• Maintains provider demographics in all applicable enrollment systems
• Adds providers to all applicable systems and maintains information to ensure claims are held/released based on status of enrollment
• Performs special projects and other duties as assigned

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 Agencies
Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.
 
Solicitation of Payment
Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.
 
Attention Candidates
Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.
To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.