Provider Enrollment Specialist

Ventra Health

. Identify provider payer enrollment issues or denials with the Provider Enrollment Manager .

Posted 10/1/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider enrollment processes, including CMS, State Medicaid, and third-party payer applications, while maintaining compliance with HIPAA regulations. Strong analytical and organizational skills are essential for managing enrollment documentation and resolving issues effectively.

Highest-signal resume keywords

Provider Enrollment ExperienceCMS Application KnowledgeHIPAA 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 ApplicationsEnrollment Documentation ManagementData AnalysisDetail OrientationDecision-MakingTime ManagementTroubleshooting

Soft Skills

Interpersonal CommunicationOrganizational SkillsTeam CollaborationInitiativeConfidentiality

Tools & Technologies

Word Processing SoftwareSpreadsheet SoftwareDatabase SoftwarePresentation Software

Certifications & Qualifications

Associate's DegreeBachelor's Degree (Preferred)

Industry Keywords

Payer EnrollmentProvider NumbersRevenue Cycle ManagementEnrollment SystemsRevalidation Dates

About the role

Key responsibilities & impact

Identify provider payer enrollment issues or denials with the Provider Enrollment Manager
Research and resolve payer enrollment issues through proprietary and external tools
Contact clients, operations personnel, CMS, and other payers by phone, email, or website
Follow up with market locations to research and resolve payer enrollment issues
Complete and submit CMS Medicare, State Medicaid, and third-party payer applications
Track and follow up to establish provider numbers and link them to the appropriate client group entities and software systems
Maintain documentation and reporting for payer enrollments in process
Retain records related to completed CMS applications
Build working relationships with clients, Operations, and Revenue Cycle Management
Obtain, track, and manage payer revalidation dates; submit and track applications to maintain active enrollment and prevent deactivation
Maintain provider demographics in applicable enrollment systems
Add providers to applicable 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 application requirements for CMS, State Medicaid, and third-party payers
Knowledge of prerequisites, required forms, completion requirements, 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

Benefits

Comp & perks

Performance-based incentive plan
Discretionary incentive bonus
Referral bonus
Remote work arrangement