EDI Enrollment Specialist – Medical Billing
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Job Description
EDI Enrollment Specialist managing electronic enrollment processes for a behavioral health platform. Collaborating with providers and handling EDI claims and troubleshooting enrollment issues.
Responsibilities:
- Responsible for electronic data interchange (EDI) processes related to Behavioral Health/Medical billing enrollment ensuring the accuracy of data during the submission process
- 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
- Review all payments being received to identify all payers that EDI, ERA and EFT can be processed through our clearinghouse
- Communicate with our clearinghouse on any enrollment issues
- Review provider enrollment denials and errors with payers to resolve denial issue in a timely manner
- Partner with the Billing Implementation team and Director, RCM Operations to enroll new payers/providers to resolve enrollment tasks
- Maintain accurate enrollment records and provide updates to Management and Clients as needed
- Document and maintain process workflows, systems configuration, and tools used in the department
- Adhere to and follow all HIPAA guidelines
- Assigned special projects as needed
Requirements:
- At least 2 years of experience in revenue cycle management (for medical billing or behavioral health billing)
- Experience with EDI enrollment including the enrollment of payers with clearing houses such as Availity, Waystar and Stedi
- Familiar with EDI file formats (such as 834 transactions)
- Experience with EDI software and systems are essential
- Experience with CredentialStream is a plus
- Self-starter comfortable working with Clients and Vendors to resolve issues in a timely manner
- Excellent oral and written communication skills
- Effective at multitasking and can demonstrate the ability to work with multiple clients at the same time
Benefits:
- PTO and Vacation Days after a 90-day introductory period
- Paid Holidays
- Generous Health, Dental & Vision benefits package
- 401k + Matching
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