EDI Enrollment Specialist

POSITION SUMMARY:

The Enrollment Specialist will be responsible for portal setup, EFT and Waystar enrollment. This individual will support the Cash Application Manager and Billing Director with setup in various portals and Waystar.

RESPONSIBILITIES:

• In depth knowledge and understanding of the entire enrollment process
• Maintain multiple payer portals to ensure timely enrollment of EFT’s (Electronic Funds Transfers) to validated bank accounts.
• Maintain multiple payer site set ups for each account to ensure timely enrollment for ERA delivery to correct account clearinghouse.
• Accuracy of information when completing all submitted enrollment forms that contain account banking data.
• Utilizing and maintaining multiple account EFT & ERA setups for multiple payer websites.
• Facilitate enrollment of EFTs ERAs in addition to portal access
• Track and follow up with payer’s intermediaries to ensure timely completion of all enrollments.
• Facilitate resolution of payer approvals and denials
• Follow up with missing EOBs when an EFT is received and ensuring that the account is set up for future EFTs.
• Prioritize multiple tasks and projects under aggressive time constraints.
• Perform other duties and/or projects as assigned by Management within the area of responsibility and control.
• Manage the Employee Access Sheet by updating passwords and access to portals.
• Track and inform direct supervisor of all ongoing missing information issues, especially pre-certs and verifications or claim errors.

The successful candidate will possess a combination of relevant employment, educational, and life experience that demonstrates the ability to do the job. They will be comfortable balancing tasks of varying levels of urgency and complexity and work well under pressure with tight deadlines and standard procedures.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job-related duties as required by their manager, subject to reasonable accommodation.

JOB REQUIREMENTS:

Education: High school diploma or equivalent required, bachelor's degree preferred

Experience:

• High level of knowledge on reimbursement guidelines as it pertains to an explanation of benefits.
• Knowledge of patient billing terminology and collections.
• 1-2 years of experience posting insurance payments in a healthcare setting preferred.
• 1-2 years Prior experience in medical billing and insurance follow up reimbursement preferred.
• IOM experience is a plus.
• 1 year working knowledge of CPT and ICD-10 CM codes and electronic claim filing.

Skills:

• Ability to work independently and interact well within a team environment.
• Microsoft 365 applications (Outlook, Teams, Word, Excel)
• Strong attention to detail, providing feedback when necessary.
• Ability to stay organized and complete tasks in a timely manner.
• Analytical skills experience and sound judgment to make decisions.
• Basic typing and 10-key skills are a must.

WORKING CONDITIONS
Working conditions are normal for an office environment.