Provider Enrollment Specialist

Ventra Health

. Work with the Provider Enrollment Manager to identify provider payer enrollment issues or denials .

Posted 11/11/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in provider enrollment processes, including CMS, State Medicaid, and third-party payer applications. Strong analytical and communication skills are essential for resolving enrollment issues and maintaining accurate provider information.

Highest-signal resume keywords

Provider Enrollment ExperienceCMS Application RequirementsHIPAA Privacy & Security KnowledgeAnalytical Problem-Solving SkillsStrong Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider EnrollmentCMS ApplicationsState Medicaid ApplicationsThird-Party Payer ApplicationsData ManagementEnrollment Package VerificationDetail OrientationAnalytical SkillsDecision-Making SkillsTime Management

Soft Skills

Interpersonal CommunicationOrganizational SkillsTeam CollaborationInitiativeJudgment

Tools & Technologies

Word Processing SoftwareSpreadsheet SoftwareDatabase SoftwarePresentation Software

Industry Keywords

Provider EnrollmentPayer Enrollment IssuesRevenue Cycle ManagementConfidentialityEnrollment Status Maintenance

About the role

Key responsibilities & impact

Work with the Provider Enrollment Manager to identify provider payer enrollment issues or denials
Research, resolve, and enroll payer issues using proprietary and external tools
Contact clients, operations personnel, CMS, and other payers by phone, email, or website
Research and resolve payer enrollment issues with market locations and payers
Complete and submit CMS Medicare, State Medicaid, and third-party payer applications
Track and follow up to establish provider numbers and link them to appropriate client group entities and software systems
Maintain documentation, reporting, and records for payer enrollments and completed CMS applications
Build working relationships with clients, Operations, and Revenue Cycle Management
Track payer revalidation dates and submit applications to maintain active enrollment and prevent deactivation
Maintain provider demographics and enrollment status in applicable systems
Add providers to systems and maintain information so claims are held or released based on enrollment status
Perform special projects and other assigned duties

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 CMS, State Medicaid, and third-party payer application requirements, prerequisites, forms, supporting documentation, and regulations
Working knowledge of physician HIPAA Privacy & Security policies and procedures
Strong oral, written, and interpersonal communication skills
Strong word processing, spreadsheet, database, and presentation software skills
Strong detail orientation, analytical, decision-making, problem-solving, organizational, and time management skills
Ability to complete and verify complex enrollment packages
Ability to work independently and in a team-oriented, collaborative, fast-paced environment
Ability to maintain strict confidentiality regarding protected provider and health information
Ability to troubleshoot, take initiative, exercise sound judgment, and handle sensitive information appropriately
Ability to communicate with diverse personalities professionally

Benefits

Comp & perks

Full-time day shift
Eligibility for Ventra's performance-based incentive plan
Discretionary incentive bonus in accordance with company policies
Referral bonus opportunity