EDI Enrollment Specialist (Medical Billing)

RethinkFirst•Orlando, FL

10d•Remote

About The Position

Rethink Behavioral Health is the leading global provider of online research-based resources to support individuals with developmental disabilities. Our behavioral health platform (http://RethinkBH.com) provides clinical, staff training and practice management tools for private ABA service providers. Due to autism insurance mandates sweeping the nation, our behavioral health division is experiencing unprecedented growth. Therefore, we are looking for the right person to join our billing service team. Our office specializes in Revenue Recycle Management, as well as Enrollment and Credentialing Services, for behavioral health providers. We support mission-oriented companies that impact the lives of thousands of individuals with autism and their families. We are excited to offer the opportunity for professional and collaborative individuals to be a part of a growth-oriented business. As an EDI Enrollment Specialist, you will be responsible for Government and Commercial payer enrollment. This position covers initial enrollment for new payers with the clearinghouse, CAQH application monitoring services as well as revalidation enrollment when needed. You will be working directly with providers and the clearinghouse (Waystar, Availity, Steadi etc..), insurance representatives, CAQH and our clients for enrollments as well as troubleshooting any enrollment issues that arise.

Requirements

You have at least 2 years of experience in revenue cycle management (for medical billing or behavioral health billing)
You have experience with EDI enrollment including the enrollment of payers with clearing houses such as Availity, Waystar and Stedi.
You are familiar with EDI file formats (such as 834 transactions) and experience with EDI software and systems are essential.
You are a self-starter comfortable working with Clients and Vendors to resolve issues in a timely manner.
You must have excellent oral and written communication skills
You are effective at multitasking and can demonstrate the ability to work with multiple clients at the same time.
You possess the ability to communicate with individuals at all levels of the organization

Nice To Haves

Experience with CredentialStream is a plus

Responsibilities

Is responsible for electronic data interchange (EDI) processes related to Behavioral Health/Medical billing enrollment ensuring the accuracy of data during the submission process.
You'll prepare and submit applications to configure Electronic Data Interchange (EDI) claims and Electronic Remittance Advice (ERA) through clearinghouse and other payer portals
You'll 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.
You will review provider enrollment denials and errors with payers to resolve denial issue in a timely manner. This includes working directly with the payers and providers.
You will partner with the Billing Implementation team and Director, RCM Operations to enroll new payers/providers to resolve enrollment tasks
You will maintain accurate enrollment records and provide updates to Management and Clients as needed
You will document and maintain process workflows, systems configuration, and tools used in the department.
You must adhere to and follow all HIPAA guidelines
You will be assigned special projects as needed