EDI Enrollments Specialist

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Requirements:

• 2 year of experience in revenue cycle management (for medical billing or within healthcare/healthtech)
• Experience with EDI enrollment, Change Healthcare experience is a plus
• An investigative mindset and you are comfortable running down problems and suggesting actions based on data
• Self starter
• Excellent oral and written communication skills
• Effective multitasking skills

Responsibilities:

• Prepare and submit applications to configure Electronic Data Interchange (EDI) claims and Electronic Remittance Advice (ERA) through clearinghouse and other payer portals
• Prepare and submit applications to configure Electronic Funds Transfer (EFT) with payers
• Initiate investigation with payers regarding provider enrollment denials and errors
• Review correspondence received from payers and action appropriately for resolution
• Work as a liaison between the RCM department and Strategy & Operations team to discuss, investigate, and resolve enrollment tasks
• Interact with our customers through excellent written and verbal communication
• Maintain up-to-date and accurate enrollment records within the Candid Health product
• Meet and maintain KPIs/metrics for production and quality
• Maintain working knowledge of workflow, systems, and tools used in the department
• Maintain HIPAA guidelines