versemedical - RCM Enrollments Specialist
Requirements
• 3+ years of experience in Revenue Cycle Management, specifically focused on Enrollments or EDI Management. • Experience working within a DME (Durable Medical Equipment) environment is highly preferred. • Proven track record of managing enrollments across a large, national payer base (Commercial, Medicare, and Medicaid). • Deep technical expertise in HIPAA standard transactions: 270/271, 837, and 835. • Proficiency with major clearinghouse platforms. • Strong proficiency in Excel for tracking high-volume enrollment statuses and project management. • Industry Knowledge • Comprehensive understanding of payer-specific enrollment portals and paper-based enrollment requirements. • Familiarity with NPI, Tax ID, and PTAN configurations in relation to electronic billing. • Exceptional organizational skills with the ability to manage thousands of moving parts simultaneously. • Relentless follow-through, you don't stop until the connection is live. • THE PEOPLE YOU’LL WORK WITH • You will report to the RCM Director and work closely with the Billing Team, Payer Relations, and Engineering. As the "bridge" between our company and our payers, you will play a foundational role in ensuring our revenue cycle operations run smoothly as we grow. • LIFE AT THE COMPANY • We foster a collaborative and innovative environment where every team member's contribution is valued. We offer competitive benefits, professional development opportunities, and a culture that prioritizes work-life balance and continuous improvement. • OUR PLEDGE FOR AN EQUITABLE FUTURE
Responsibilities
• Manage and execute the end-to-end enrollment process for EDI (Electronic Data Interchange), EFT (Electronic Funds Transfer), and ERA (Electronic Remittance Advice) for a national network of thousands of payers. • Proactively add and configure new payers to the system as the company expands its network and footprint. • Serve as the internal subject matter expert for clearinghouse operations and payer-specific enrollment requirements. • Investigate and resolve electronic connection issues, identifying root causes for transmission failures or "missing" ERAs. • Audit existing payer connections regularly to ensure EFT/ERA setups are active and funds are being routed correctly. • Monitor the health of 270/271 (Eligibility) and 837/835 (Claims/Remittance) transaction loops to minimize manual intervention. • Coordinate with Payer Relations and Finance teams to ensure all enrollment data aligns with credentialing and banking requirements.
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