Job Title: Payer/EDI Enrollment Specialist

· The EDI Enrollment Specialist works closely with Billing, Accounts Receivable (AR), Payment Posting, Credentialing, Client Success, Implementations, Clearinghouses, and U.S.-based teams to establish and maintain electronic connectivity, resolve enrollment-related issues, and minimize reimbursement delays.

· The role requires strong attention to detail, proactive payer follow-up, effective issue resolution, and accurate documentation to support operational efficiency and compliance.

· Key Responsibilities:

· EDI Enrollment Management

· Prepare, submit, monitor, and maintain EDI enrollment requests for electronic transactions, including Electronic Claims (837), Electronic Remittance Advice (ERA/835), Electronic Funds Transfer (EFT), Claim Status transactions (276/277), and Eligibility transactions (270/271), where applicable.

· Complete payer-specific electronic enrollment applications through payer portals, clearinghouses, and paper enrollment processes, as required.

· Coordinate EDI enrollments with clearinghouses and insurance payers to establish electronic connectivity for assigned providers and client groups.

· Validate provider demographic information, National Provider Identifier (NPI), Tax Identification Number (TIN), billing information, and banking details before submission to ensure accuracy.

· Track enrollment status, payer responses, effective dates, approvals, and activation milestones through completion.

· Payer & Clearinghouse Follow-Up

· Perform timely follow-up with insurance payers and clearinghouses to obtain enrollment status, resolve deficiencies, and expedite approvals.

· Investigate and resolve rejected, delayed,



or incomplete EDI enrollment requests.

· Escalate aging enrollments, payer delays, or connectivity issues that may impact claims submission or payment processing.

· Maintain consistent communication with internal stakeholders regarding enrollment progress, risks, and expected completion timelines.

· Documentation & Quality

· Maintain accurate documentation within enrollment systems, work queues, trackers, CMD records, and document repositories.

· Document payer communications, enrollment approvals, rejection reasons, and corrective actions in accordance with RCMS documentation standards.

· Ensure all enrollment records are complete, current, and audit-ready.

· Safeguard sensitive provider and banking information while adhering to HIPAA and organizational security requirements.

· Cross-Functional Collaboration

· Partner with Credentialing, Billing, AR, Payment Posting, Client Success, Implementations, and U.S.-based teams to support provider onboarding and revenue cycle readiness.

· Coordinate with internal departments to resolve enrollment dependencies affecting electronic claims submission or payment processing.

· Support recent client implementations, provider onboarding, and organizational growth initiatives by ensuring timely EDI setup.

· Identify process improvement opportunities to reduce enrollment turnaround times, improve first-pass approval rates, and standardize EDI workflows.

· Assist in training team members and sharing payer-specific EDI enrollment knowledge and best practices.

This is an onsite position, 5 days/week, in the Vadodara office working the NIGHT SHIFT. Hours are 6:30pm-3:30am IST. Remote applicants will not be considered.

📌 Payer Enrollment Specialist - RCMS (Vadodara)
🏢 IHCS Technologies India Private
📍 Vadodara