RCM EDI Enrollment Specialist

The RCM EDI Enrollment Specialist is responsible for implementing and maintaining clearinghouse connectivity for the Azalea Health Revenue Cycle Management Department. This role operates under the direct supervision of the Senior Manager of RCM Success.

• Act as the RCM EDI Enrollment SME in all areas of the process, including clearinghouse portals and troubleshooting issues.
• Train RCM team members in the EDI Process and Azalea RCM Specific SOPs.
• Support the development of Standard Operating Procedures (SOPs) in collaboration with the RCM Operations Leadership.
• Maintain and consistently strive for 95% EDI Enrollment Rate.
• Maintain and consistently strive for 95% ERA Enrollment Rate.
• Implement and onboard new RCM client clearinghouse functions.
• Review and maintain clearinghouse functions for all Azalea RCM current clients.
• Develop and maintain all areas of clearinghouse functions, including EDI enrollments, ERA analysis and enrollment, EFT transfers as needed, and clearinghouse reporting.
• Effectively communicate issues affecting clearinghouse enrollments to other RCM employees as necessary.
• Communicate and record trends, analysis, areas of improvement to RCM employees and management.
• Oversee payer website access and direct enrollments.
• Perform Quality Assurance tasks and review on accounts when requested.
• Maintain HIPAA compliance when handling patient protected health information (PHI).
• Monitor and audit clearinghouse enrollments for all RCM clients.
• Maintain excellent relationships with 3rd party vendors and clients.
• Perform other Revenue Cycle Management-related duties as assigned.

• Excellent ICD-10, CPT, and HCPCS coding knowledge and skills.
• Minimum 2 to 3 years experience in Revenue Cycle Management or healthcare administration required.
• Excellent computer and internet skills.
• Strong attention to detail.
• Strong organizational skills.
• Strong oral and written communication skills.
• Strong analytical and problem-solving skills.
• Experience performing clearinghouse enrollments preferred but not required.
• Bachelor's degree in healthcare management field preferred; CPC/CPB designation is a plus.

• Competitive and comprehensive benefits, including full medical, dental, vision, and life insurance.
• Generous employer-sponsored subsidy towards employee's medical insurance premiums.
• Azalea Health covers 100% of the premiums for Life AD&D and Long-Term Disability for all eligible full-time employees.
• Balance and flexibility, with simple Paid Time Off (PTO) options.
• Economic opportunity, with a competitive total rewards package that offers competitive pay and advancement opportunities.