Ventra 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.
As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards.
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Facilitates resolution of contract variances and other contract discrepancies. Communicates with payers and other departments within the organization regarding managed care projects. Provides regular feedback to Client Services, Posting, and Call Center teams regarding contract variance status. Maintains contract files
Maintains daily, weekly, and monthly reporting requirements assigned to the Managed Care team
Identifies and resolves contract variances, which may include working with other departments internally; working directly with payers; and reviewing contract language/rates.
Loads and manages non-par processes
Answers questions and provides training and managed care related guidance to other departments within our organization
Conducts contract performance reviews on all new and renegotiated contracts to ensure accurate reimbursement. Analyzes accounts receivable for expected outcomes from renewal and renegotiations
Submits project appeals related to contract performance issues for all specialties
Performs special projects and other duties as assigned
High School Diploma or GED
At least three (3) years of experience in medical billing
Knowledge of State, Federal, and Managed Care regulatory guidelines
Knowledge of benefit insurance billing contract management
Strong oral, written, and interpersonal communication skills
Strong decision-making skills
Strong problem-solving skills
Strong time management skills
Basic word processing, spreadsheet, database, and presentation software skills
Basic mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages; and working with decimals
Ability to read, understand, and apply state/federal laws, regulations, and policies
Ability to exercise sound judgment and handle highly sensitive and confidential information appropriately
Ability to remain flexible and work within a collaborative and fast paced environment
Ability to communicate with diverse personalities in a tactful, mature, and professional manner
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 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 Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.
Statement 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 https://ventrahealth.com/statement-of-accessibility/.
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