EDI Enrollment Specialist

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.

• The EDI Enrollment Specialist is responsible for the setup, verification, and maintenance of provider and facility enrollments in clearinghouses (e.g., Athena, PhiCure) for electronic claims (EDI), remittance advice (ERA), and electronic fund transfers (EFT). This role ensures accurate enrollment tracking, monitors pending approvals and signatures, and resolves enrollment-related escalations, such as missing ERA remits or rejected EDI claims.

• Set up new facility and provider enrollments in clearinghouses (Athena, PhiCure).
• Process new EDI enrollments to enable claims submission.
• Enroll providers in ERA to replace paper EOBs with electronic remittance advices.
• Enroll providers in EFT for direct deposit payments.
• Verify successful enrollment for claims, ERAs, and EFTs.
• Track, research, and confirm file transmissions to clearinghouses and payers.
• Troubleshoot failed transmissions and claim edit issues.
• Manage pending payor approvals and signatures.
• Address issues such as unexpected paper checks, incorrect payments, or EDI rejections.
• Collaborate with internal teams on escalations.
• Perform special projects and other duties as assigned.

• High School Diploma or GED required.
• Experience in healthcare access administration, medical billing operations, or healthcare IT support.

• Strong knowledge of EDI/ERA/EFT enrollment processes, clearinghouse systems (Athena, PhiCure), and electronic remittance workflows.
• Strong oral, written, and interpersonal communication skills.
• Strong problem-solving skills.
• Strong independent and critical decision-making skills.
• Strong organizational skills.
• Strong time management skills.
• Strong word processing, spreadsheet, database, and presentation software skills.
• Strong detail orientation skills.
• Ability to communicate technical information to technical and nontechnical personnel at various levels in and across the organization.
• Ability to work well under pressure with good communication skills.
• Ability to take initiative and effectively troubleshoot while focusing on innovative solutions.
• Ability to exercise sound judgment and handle highly sensitive and confidential information appropriately.
• Ability to remain flexible and work within a collaborative and fast-paced environment.

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/. 

Statement of Accessibility
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