Enrollment Specialist

2 weeks ago

Marion, United States RHA Health Services Full time
We are hiring for:
Enrollment Specialist
Type:
Regular

If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, join our team at RHA Health Services

The Billing Enrollment Specialist serves as a vital consultant, advisor, and problem solver for all enrollment-related processes to ensure accurate and efficient billing operations. This role requires close collaboration with local operational leadership and corporate functions to align with business and operational goals. Billing Enrollment Specialist brings a proactive approach to problem-solving and thrives in a dynamic, detail-oriented environment.
MINIMUM QUALIFICATIONS:
  • High School Diploma or GED; Bachelor's degree preferred.
  • 1-2 years of office experience, preferably in a medical office setting.
  • Previous supervisory experience is a plus
  • Familiarity with insurance authorization processes and payer systems.
  • Strong proficiency in Microsoft Office Suite, particularly Excel and Outlook.
  • Exceptional verbal, written, and interpersonal communication skills.
  • Valid driver's license and automotive insurance.
DUTIES AND RESPONSIBILITIES:
  • Act as a liaison between the Referral Team and local operations to streamline patient referrals and enrollment processes.
  • Ensure accurate and thorough entry of demographic information in the Electronic Health Record (EHR) system for claims and billing purposes.
  • Conduct regular audits to identify inconsistencies and missing data, ensuring all issues impacting billing are addressed promptly.
  • Actively participate in operational planning meetings related to new admissions, transfers, and discharge services.
  • Verify, confirm, and evaluate payer benefits for Medicaid, Medicare, and third-party commercial plans.
  • Review benefits and establish self-pay agreements when appropriate.
  • Maintain and manage payer records and authorizations within the EHR system.
  • Assist with resolving billing event discrepancies to ensure accuracy.
  • Research and resolve denied claims efficiently and effectively.
  • Complete individual admissions, including enrollment and intake documentation.
  • Create and manage Managed Care Organization (MCO) enrollments and profiles.
  • Ensure compliance with HIPAA and other regulatory standards during data entry and billing processes.
  • Maintain detailed records of billing activities and payer communications for audit and review purposes.
  • Train local staff on billing and enrollment processes to ensure consistency across teams.
  • Serve as a point of contact for operational staff to address EHR or billing system inquiries.
  • Generate and analyze monthly reports on billing and enrollment performance metrics to identify trends and areas for improvement.
  • Provide insights to leadership regarding payer trends, denied claims, and revenue cycle improvements.
  • Identify opportunities for improving EHR workflows related to billing and enrollment.
  • Work closely with accounts receivable to ensure accurate posting of payments and reconciliation.
  • Assist in forecasting billing revenue based on enrollment trends and payer agreements.
  • Perform additional duties as assigned.
SUPERVISORY RESPONSIBILITIES:

This position has no supervisory responsibilities

PHYSICAL DEMANDS AND WORK ENVIRONMENT:
  • Ability to perform tasks requiring sustained physical activity, such as sitting, standing, walking, or repetitive hand movements.
  • Frequent use of standard office equipment, including computers, phones, and other peripherals.
  • Ability to lift and carry items within a reasonable weight range, if necessary.
  • Regular use of technology and exposure to prolonged periods of screen time.
RHA is an Equal Employment Opportunity Employer, prohibits discrimination based on the following protected categories: race, creed, color, national origin, nationality, ancestry, age, sex/gender, marital status, civil status, domestic partnership status, familial status, religion, affectional or sexual orientation, gender identity or expression, atypical hereditary cellular or blood trait, genetic information, liability for service in the Armed Forces of the United States, or disability.

Pre-employment screening:
  • Complete criminal background
  • Name checked in the registries. (OIG exclusions database, Child Abuse Registry, and Offenders Against Individuals with Developmental Disabilities)
  • Drug testing
  • Education verification and other credentialing based on position requirements.
  • Proof of employment history or references (if required)
  • Positions that require driving Proof of driver's license, driver's insurance, and vehicle, IF required for providing transportation for individuals.
We offer the following benefits to employees:
  • Payactiv: early access to the money you've earned from hours you've already worked, before payday
  • Employee perks and discount program: to help you save money
  • Paid Time Off (full-time employees only)
  • Health/Insurance (full-time employees only)
  • 401(k) retirement savings program
  • Wellbeing Programs: Physical, Emotional and Financial
  • Chronic Disease management programs for hypertension and diabetes (for qualifying employees)
  • Training: Free CPR, first aid, and job-specific training opportunities

*contract/contingent workers and interns do not qualify for any of the above benefits

EEO Statement RHA is an equal opportunity employer. In addition, we provide reasonable accommodation to qualified employees who have protected disabilities to the extent required by applicable laws, regulations, and ordinances. If you are an individual with a disability and need a reasonable accommodation to participate in the application process, please contact our solutions center.

About RHA:

At RHA Health Services, we help individuals with intellectual and developmental disabilities, mental health and/or substance use needs live their best lives. Our mission is to provide a safe and healthy environment while creating opportunities for personal outcomes.

For over 30 years, the people we serve and support have remained at the very center of everything we do. RHA currently provides services in North Carolina, Georgia, Pennsylvania, Tennessee, and New Jersey.

If you are ready to make a difference in the lives of people we serve and support apply to join the team today.

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