Job Description

ClinicMind, the nation's leader in multi-specialty Electronic Healthcare Records (EHR) software and Revenue Cycle Management (RCM) services, is looking for an Enrollment Specialist. If you're excited to be part of a winning team, ClinicMind is a perfect place to get ahead.



We are seeking a detail-oriented and proactive Payer Enrollment Specialist to join our team. The Payer Enrollment Specialist will be responsible for managing the enrollment process with various healthcare payers, ensuring ensuring seamless integration of EDI and ERA services, and enabling efficient claims submission, payment processing, and reconciliation.



Key Responsibilities:



1. Managing EDI and ERA Enrollment Process


• EDI Enrollment: Facilitate the enrollment of healthcare providers for EDI services with various payers, ensuring seamless electronic data exchange for claims submission and processing.
• ERA Enrollment: Oversee the enrollment process for Electronic Remittance Advice (ERA), ensuring that providers receive electronic payment and remittance advice from payers.

2. Communication and Coordination


• Liaison with Payers: Communicate with insurance companies to obtain necessary forms and documentation for EDI and ERA enrollments, ensuring timely submission and activation of services.
• Internal Collaboration: Coordinate with internal departments to gather required information and documentation from providers and streamline the enrollment process.

3. Record Maintenance and Monitoring


• Enrollment Tracking: Maintain accurate records of EDI and ERA enrollments, including submission dates, activation status, and any communication with payers.
• Monitoring Activation: Monitor the activation of EDI and ERA services for providers, ensuring successful implementation and troubleshooting any issues that may arise.

4. Compliance and Reporting


• Regulatory Compliance: Stay informed about EDI and ERA enrollment requirements, regulations, and industry standards to ensure compliance with payer guidelines.
• Documentation and Reporting: Ensure all documentation related to EDI and ERA enrollments is completed accurately and in accordance with payer specifications, and generate reports as needed



Qualifications:


• Bachelor's degree in any STEM domain (preferred) or medical doctorate
• More than 1 year of Previous experience in payer enrollment, specifically with a focus on Electronic Data Interchange (EDI) and Electronic Remittance Advice (ERA) enrollments.
• In-depth understanding of EDI and ERA enrollment processes, including familiarity with EDI transaction sets (such as ANSI X12) and ERA formats (such as ANSI 835).
• Proficiency in using EDI enrollment tools and platforms, with experience in submitting EDI enrollment forms and managing EDI setup processes.
• Strong communication and interpersonal skills, with the ability to effectively liaise with insurance companies and internal stakeholders to facilitate enrollment activities.
• Excellent organizational skills and attention to detail, with the ability to maintain accurate records of enrollment activities and monitor enrollment status.
• Knowledge of regulatory requirements and industry standards related to EDI and ERA enrollments, including HIPAA regulations and payer-specific enrollment guidelines.
• Ability to work independently and prioritize tasks in a fast-paced environment, with a proactive approach to problem-solving and troubleshooting.
• Proficiency in Microsoft Office applications, with experience in generating reports and analyzing enrollment data.

MUST HAVE:



• High comfort level working on Eastern Time Zone/US Shift


• Good internet access at home at least 25 MBPS


• Mobile Hotspot


• Laptop/Desktop of at least 16 GB