Revenue Cycle EDI Enrollment Specialist

Integrative Emergency Services•Dallas, TX

10d•Hybrid

About The Position

Integrative Emergency Services, LLC (“IES”) is seeking a Revenue Cycle EDI Enrollment Specialist (ESS) who will be responsible for facilitating and managing provider enrollment for all new and existing clients. The EES is responsible for completing and/or overseeing vendor management for all EFT/ERA enrollment submissions for the appropriate payors, providing payor portal access to the appropriate entities, and updating remittance and demographic information for all entities. This specialist will develop, coordinate, implement, and manage all payer/EDI-related processes. Additionally, the EES serves as the primary link between IES and any claims/payer data-trading partners and vendors and manages those relationships. The EES’ job is to ensure all items are accurately obtained, tracked, setup, updated and communicated for each implementation and/or payer/provider change. IES is dedicated to cultivating best practices in emergency care, providing comprehensive acute care services, creating value, and supporting patients, employees, clients, providers, and physicians in pursuit of the highest quality health care.

Requirements

HS Diploma or GED equivalent
3+ years of experience working in EDI and Healthcare Revenue Management or Revenue Cycle Management, with a focus on healthcare remittance processing and enrollments
3+ years of experience with EDI, enrollment, and/or insurance portal management
3+ years of experience with billing, collections, and/or coding in revenue cycle
Working knowledge with various payer systems and basic enrollment processes (ERA vs. ACH/EFT)
Working knowledge of healthcare specific EDI standards (HIPAA, X12, HL7) and transactions sets (270s, 271s, 837s, 835s, etc)
Extensive knowledge of medical terminology and revenue cycle industry
Excellent analytical, organizational, and verbal/written communication skills
Detail orientation
Ability to manage multiple priorities
Strong customer service orientation
Ability to use discretion appropriately and maintain confidentiality
High levels of proficiency with MS Office applications
Ability to function in a hands-on environment
Ability to read, write and speak English proficiently

Nice To Haves

Bachelors Degree in Healthcare Management, Business, Project Management, or a related field

Responsibilities

Will be responsible for managing the payor linking process including the development of linking strategies for account processing and establishing procedures for access management.
Will be responsible for setting up new group forms with RCM vendors for EDI.
Will manage and set-up new group administrator access across all payor websites and manage client profiles across all platforms and all websites for all groups.
Will oversee EFT and ERA enrollment for all groups and all payors.
Will manage website access for IES and its vendors.
Will manage all profile attestations for payor linking.
Will manage reporting and processes to redirect paper mail to lockbox and/or convert to ERA and EFT/ACH.
Manages the processes associated with new and change payer set ups as it relates to 270/271 eligibility, 835/837 files and EFT’s.
Responsible for updating workflow processes and documentation related to payor linking (EDI, EFT, and/or ERA).
Manage bank account and address linking for all groups.
Collaborates with vendor(s) and serves as the primary contact for payor linking.
Research and compile new payor contract and/or enrollment scoping for all groups and all payors.
Source primary contact and/or process for payor contracting and present to leadership.
Assist with research through payor websites as applies to new or existing payor contracts.