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Provider Enrollment Specialist
Medsuite IncProvider Enrollment Specialist resolving payer enrollment issues for Ventra Health. Collaborating with clients and government services to ensure provider enrollments.
About the role
Key responsibilities & impact- Works in conjunction with the Provider Enrollment Manager to identify Provider Payer Enrollment issues or denials.
- Researches, resolves, and enrolls any payer issues, utilizing a variety of proprietary and external tools.
- Contacts 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.
- Manages the completion and submission of CMS Medicare, State Medicaid and any other third-party payer applications.
- Maintains documentation and reporting regarding payer enrollments in process.
- Establishes close working relationships with Clients, Operations, and Revenue Cycle Management team.
Requirements
What you’ll need- Associate's degree (2 years), required
- Bachelor's degree in any related field, preferred
- At least one (1) year of provider enrollment experience preferred.
- Working knowledge of specific application requirements for Centers for Medicare & Medicaid Services (CMS), State Medicaid and all third-party payers
- Working knowledge of physician HIPAA Privacy & Security policies and procedures
- Strong word processing, spreadsheet, database, and presentation software skills
- Ability to ensure the complex enrollment packages are complete and correct
- Ability to work independently and require little supervision, to focus on and accomplish tasks
- Ability to maintain strict confidentiality with regards to protected provider and health information
Benefits
Comp & perks- Ventra performance-based incentive plan
- Referral bonus
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
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Hard Skills & Tools
Provider EnrollmentCMS Application RequirementsState Medicaid Application RequirementsPayer Enrollment Issue ResolutionDatabase ManagementSpreadsheet ProficiencyWord Processing SkillsPresentation Software Skills
Soft Skills
Independent WorkAttention to DetailConfidentiality MaintenanceStrong Communication
Certifications
Associate's Degree