Director, Provider Enrollment
Director, Provider Enrollment
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Job Description
About Us
Ventra is a leading business solutions provider for facilitybased 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 datadriven solutions that solve the most complex revenue and reimbursement issues enabling clinicians to focus on providing outstanding care to their patients and communities.
Job Summary
- Under administrative direction the Director of Provider Enrollment oversees the Provider Enrollment team and the daytoday Enrollment operations.
Essential Functions and Tasks
- Directs leads and manages the Provider Enrollment departments 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 teams 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 workflow 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 departmentwide 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 Requirements
- High School diploma or equivalent
- Bachelors 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 Abilities
- Knowledge of provider enrollment requirements for physician billing and multistate 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 decisionmaking skills
- Strong problemsolving 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 Health
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 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 of Accessibility
Ventra Health is committed to making our digital experiences accessible to all users regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at Experience:
Director
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