Portfolio Company Positions

Job Description

Revenue Management Solutions (RMS) is seeking a highly motivated and detail-oriented EDI Enrollment Specialist to join our team for EOB to ERA clearinghouse enrollments and paper check to ACH/EFT processing for healthcare providers. As a leader in healthcare revenue management, RMS is dedicated to maximizing clients' revenue potential by reducing manual errors and enhancing efficiency across the entire revenue cycle.

This role will focus on successfully managing projects related to ERA and ACH/EFT enrollments, ensuring successful implementation and ongoing support for both new and existing clients. This role involves working closely with clients to understand their needs, managing internal and external project initiatives, creating comprehensive payer plans, managing timelines and resources, and ensuring projects are delivered successfully and on time.

The ideal candidate will understand healthcare remittance and enrollment processes, experience in client engagement, and strong organizational skills.

Key Responsibilities

• Assist in managing enrollment projects for client EOB to ERA clearinghouse and paper check to ACH/EFT processing, supporting successful implementation.
• Collaborate with clients to understand their needs and provide basic payer analysis to improve their revenue cycle efficiency.
• Support the development of payer plans and contribute to the execution of enrollment processes and timelines.
• Help coordinate internal and external enrollment project initiatives, ensuring tasks are completed on time.
• Build and maintain relationships to encourage effective communication during the enrollment process.
• Monitor enrollment project outcomes and identify areas for improvement under supervision.
• Participate in training sessions for clients on RMS products and solutions, helping to explain process workflows and product/service features.
• Occasional travel to client sites may be required.
• Perform additional duties and responsibilities as assigned.

Qualifications

• Relevant experience in EDI and Healthcare Revenue Management or Revenue Cycle Management, with a focus on healthcare remittance processing and enrollments.
• Ability to work effectively in a dynamic environment and manage multiple tasks.
• Basic understanding of process improvements and operational efficiency.
• Familiarity with various payer systems and basic enrollment processes (ERA vs. ACH/EFT).
• Understanding of the healthcare revenue cycle, including claims and payments.
• Knowledge of ANSI X12/EDI healthcare transaction sets, particularly 837s and 835s, at a foundational level.
• Good written and verbal communication skills, with the ability to convey technical information to non-technical audiences.
• Strong organizational skills and attention to detail.

Education & Experience

• Bachelor’s Degree in Healthcare Management, Business, Project Management, or a related field is preferred.
• 2+ years of relevant experience is required.
• Certified Revenue Cycle Representative (CRCR) is preferred.
• Project Management Professional (PMP) or Certified Associate in Project Management (CAPM) is preferred.
• Proficiency in Microsoft Office applications is required.
• Experience with Agile software, Confluence, and CRM solutions is preferred.

Environmental Conditions

• Hybrid or Remote.
• Indoor climate-controlled environment.

• Moderate to quiet noise level.

Physical Requirements

While performing the duties of this Job, the employee is regularly required to communicate verbally and in the written form. The employee is physically required to utilize a laptop and other electronic devices effectively. The employee must lift and/or move up to 20 pounds (laptop computer, bag, and accessories). Specific vision abilities required by this job include close vision and distance vision.