Director, Provider Enrollment

About UsVentra 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. Job SummaryUnder administrative direction, the Director of Provider Enrollment oversees the Provider Enrollment team and the day-to-day Enrollment operations.

Essential Functions and TasksDirects, leads, and manages the Provider Enrollment department's day to day operations, recruits, selects, orients, trains, coaches, counsels, and disciplines staff

Develops relationships with the Provider Enrollment teams and documents needs and organizational priorities

Ensures success of the provider enrollment lifecycle by monitoring client level metrics as well as ensuring timeliness and accuracy of team's enrollment activities related to new enrollment, reenrollment, enrollment denials and client level special projects

Develops relationships with clients and provides regular status updates on credentialing related deliverables

Makes recommendations on work-flow processes throughout the enrollment cycle to assist in achieving consistency and success

Develops and makes recommendations on policies, guidelines, and implements procedures to ensure consistent department-wide implementation and adherence

Holds monthly (or as warranted) meetings with all levels of management to review held claims, status of client provider enrollment, overall provider enrollment inventory, etc.Monitors timeliness and effectiveness of department activities, implements processes to identify gaps

Compiles and prepares a variety of reports for management in order to analyze trends and make recommendations

Performs special projects and other duties as assigned

Education and Experience RequirementsHigh School diploma or equivalent

Bachelor's Degree in Healthcare Administration, Business Administration, Benefits, or equivalent training and/or experience preferred

At least five (5) years of physician billing, hospital billing, or vendor management experience in provider enrollment functions

At least two (2) years of supervisory/management/leadership experience preferred

Experience with CAQH database, NPI website and maintaining EDI, EFT, and ERA processes preferred

Knowledge, Skills, and AbilitiesKnowledge of provider enrollment requirements for physician billing and multi-state experience preferred

Knowledge of business and financial processes, procedures, and processes

Knowledge of medical terminology and anatomy

Knowledge of requirements of medical record documentation

Strong supervisory/management skills

Strong leadership development and team building skills

Strong management level oral, written, and interpersonal communication skills

Strong financial reporting skills

Strong healthcare data analysis skills

Strong presentation development and delivery skills

Strong word processing, spreadsheet, database, and presentation software skills

Strong decision-making skills

Strong problem-solving skills

Strong organizational skills

Strong time management skills

Strong mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages, areas, and volumes; and working with decimals

Ability to effectively present information, including financial reporting and healthcare analytics, and respond to questions from groups of executives, managers, clients, and customers

Ability to adapt communication style to suit different audiences

Ability to communicate with business stakeholders and IT staff in a tactful, mature, and professional manner

Ability to know how and when to involve key players and effectively use internal employer resources to provide the best solution

Ability to initiate and maintain professional relationships.Ability to see reoccurring issues and fixing them or identify and solve front end issues Ability to communicate with diverse personalities in a tactful, mature, and professional manner

Ventra HealthEqual 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 AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.

Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement. Attention CandidatesPlease 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 ******* to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on

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