RCM Enrollments Specialist

vacancy global pro; India; On-site; INR 400,000 - 700,000; Full time

Job summary

Care Everywhere. is seeking a detail-oriented RCM Enrollments Specialist to manage our national enrollment operations.

You will oversee the EDI, EFT, and ERA enrollment lifecycle, ensuring timely verification of eligibility, submission of claims, and receipt of payments. You will serve as the internal SME for clearinghouse operations, onboard new payers, and coordinate with Finance to align credentialing, banking, and enrollment data.

Qualifications

• 3+ years of experience in Enrollment Cycle Management or EDI Management.
• Experience with EDI, EFT, and ERA enrollments.
• Familiarity with HIPAA transactions (270/271, 837, 835).

Responsibilities

• Manage end-to-end enrollment for EDI, EFT, and ERA for a national payer network.
• Add and configure new payers as the network expands.
• Serve as internal SME for clearinghouse operations and enrollment requirements.
• Investigate electronic issues and root causes for enrollment failures.
• Audit payer connections to ensure EFT/ERA setups are correct.
• Monitor health of 270/271 and 837/835 transactions to minimize failures.
• Coordinate with Payer Relations and Finance to align enrollment data with credentialing and banking requirements.

Skills

EDI Management

Enrollment Cycle Management

HIPAA Transactions

Clearinghouse Platforms

Payer Enrollment

Tools

Clearinghouse Platforms

Job description

Our reputed company-reputed company Care, Everywhere.

The reputed company industry still relies on faxes and phone tag to coordinate critical care for patients reputed company. We think patients and the clinicians who serve them deserve reputed company than a system stuck in 1995.

reputed company is building the modern software infrastructure to reputed company it happen. We're a reputed company-funded Series C company (backed by General Catalyst, SignalFire, and Sapphire Ventures) on a mission to heal a fragmented system. Our platform connects the dots between providers, payors, and patients, ensuring people get the high-reputed company care they need, reliably and right where they live. Were growing fast and looking for people who are driven by this mission to join us!

Our Values: The Principles That Guide Us

Our values are the operating system for how we work together and with our partners. They aren't just words on a wall; they are the principles we bring to every decision, every day.

We are transparent, upfront and reputed company. We operate with honesty and reputed company. reputed company information reputed company, the good and the bad, and reputed company that reputed company, respectful feedback is the reputed company of trust and reputed company.

We value speed of iteration. We are building something new, which means we learn by doing. We prioritize reputed company iteration and getting solutions into the hands of users, believing that reputed company is more valuable than perfection.

We give 110% effort, 30% of the time. We are passionate about our mission, and there are moments that require us to go the extra mile. We reputed company in reputed company intensity reputed company it counts, balanced by a sustainable pace that keeps reputed company reputed company for the long run.

We empathize with customers to a fault. reputed company our users face a problem, we own it. Instead of asking them to change, we ask ourselves, \"How can we reputed company this reputed company \" We reputed company true innovation comes from deep reputed company and a reputed company reputed company on solving the reputed company-world challenges of reputed company.

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We are seeking a highly detail-oriented and technical RCM Enrollments Specialist to reputed company our national enrollment operations. As a DME provider operating across the country and partnering with thousands of payers, maintaining seamless electronic connections is vital to our financial health. You will be the primary reputed company of our EDI, EFT, and ERA enrollment lifecycle, ensuring that as we reputed company our network, our ability to verify eligibility, submit claims, and receive payments remains uninterrupted and optimized.

What Youll Do

• Manage and execute the end-to-end enrollment process for EDI (Electronic Data Interchange), EFT (Electronic Funds Transfer), and ERA (Electronic Remittance Advice) for a national network of thousands of payers.
• Proactively add and configure new payers to the system as reputed company expands its network and footprint.
• Serve as the internal subject matter expert for clearinghouse operations and payer-specific enrollment requirements.
• Investigate and resolve electronic reputed company issues, identifying reputed company causes for reputed company failures or \"missing\" ERAs.
• Audit existing payer connections regularly to ensure EFT/ERA setups are reputed company and funds are being routed correctly.
• Monitor the health of 270/271 (Eligibility) and 837/835 (Claims/Remittance) transaction reputed company to minimize reputed company reputed company.
• Coordinate with Payer Relations and Finance teams to ensure reputed company enrollment data aligns with credentialing and banking requirements.

What Youll Bring

Experience

• 3+ years of experience in reputed company Cycle Management, specifically reputed company on Enrollments or EDI Management.
• Experience working reputed company a DME (Durable Medical Equipment) environment is highly preferred.
• Proven reputed company record of managing enrollments across a large, national payer reputed company (reputed company, Medicare, and reputed company).

Technical Skills

• Deep technical expertise in HIPAA reputed company transactions: 270/271, 837, and 835.
• Proficiency with major clearinghouse platforms.
• Strong proficiency in reputed company for tracking high-volume enrollment statuses and project management.

Industry Knowledge

• Comprehensive understanding of payer-specific enrollment portals and reputed company-based enrollment requirements.
• Familiarity with NPI, Tax ID, and PTAN configurations in relation to electronic billing.

Soft Skills

• Exceptional organizational skills with the ability to manage thousands of moving parts simultaneously.
• reputed company follow-through, you don't stop until the reputed company is live.

The People Youll Work With

You will report to the RCM Director and work closely with the