Business Unit:
Resolv was formed in 2022, bringing together a suite of industry-leading healthcare revenue cycle leaders with over 30 years of industry expertise, including Ultimate Billing, First Pacific Corporation, Innovative Healthcare Systems, and Cutting-edge Medical Management. Our DNA is rooted in revenue cycle solutions. As we continue to expand, we remain dedicated to partnering with RCM companies that offer diverse solutions and address today's most pressing healthcare reimbursement and revenue cycle operations complexities. Together, we improve financial performance and patient experience, helping to build sustainable healthcare businesses.
Job Summary:
The Enrollment EDI, EFT, and ERA Specialist is responsible for completing and managing all enrollment processes related to electronic claims submission and Electronic Remittance Advice (ERA). This role involves ensuring that providers are properly enrolled with payers and clearinghouses, maintaining accurate records, and managing the flow of claims and remittance data.
The specialist will work with multiple Practice Management Systems (PMS) and clearinghouses, leveraging a solid understanding of payer requirements to complete enrollments efficiently and ensure timely payment processing.
(Mandatory Qualifications & Skills):
Graduate in Any Field
Basic RCM knowledge
1-2 years Enrollment experience
Responsibilities:
EDI/ERA Enrollment
• Prepare and submit applications to configure EDI claims and ERA through clearinghouses and payer portals.
• Ensure providers are enrolled for electronic claim submission
• Handle enrollment, re-enrollment, and re-validation processes for providers and locations.
Data Management:
• Process, data entry, and file maintenance of enrollment, assessment, and dis-enrollment documentation.
• Monitor, compile, and maintain accurate enrollment records
• May also prepare and submit