Enrollment Specialist

Overview

The Enrollment EDI, EFT, and ERA Specialist completes and manages enrollment processes for electronic claims submission and Electronic Remittance Advice (ERA), ensuring providers are properly enrolled with payers and clearinghouses.

What you'll do

• Prepare and submit applications to configure EDI claims and ERA through clearinghouses and payer portals.
• Ensure providers are enrolled for electronic claim submission.
• Handle enrollment, re-enrollment, and re-validation processes for providers and locations.
• Process, data entry, and file maintenance of enrollment, assessment, and dis-enrollment documentation.
• Monitor, compile, and maintain accurate enrollment records.
• May prepare and submit applications to configure Electronic Funds Transfer (EFT) with payers.
• Verify enrollment status, make changes to membership records, research and resolve enrollment system discrepancies, process membership terminations, and other forms of enrollment events.
• Serve as the primary point of contact for payer and clearinghouse inquiries regarding EDI, EFT, and ERA enrollments.
• Communicate effectively with internal teams to ensure smooth processing of claims and remittances.

What you'll need

• Graduate in any field.
• Basic RCM knowledge.
• 1-2 years of enrollment experience.
• Understanding of EFT setup and management processes.
• Ability to handle payment processing, troubleshoot payment issues, and ensure accurate deposit posting.
• Experience with ERA processing, including remittance retrieval, interpretation, and accurate posting to patient accounts.
• Familiarity with medical billing and clearinghouse systems.
• Ability to navigate and configure payer systems for claim submissions and payment processing.
• Problem-solver who identifies and resolves healthcare billing discrepancies.
• Organized, manages high volumes of medical remittances efficiently.
• Clear communicator who effectively discusses payment issues with healthcare teams.
• Analytical, understands healthcare financial data and denial patterns.

Details

• Work mode: Remote.
• Shift timings: 6pm-3am (night shift).
• Location: Mumbai (Vikhroli).
• Benefits: annual public holidays as applicable, 30 days total leave per calendar year, Mediclaim policy.