RCM Enrollments Specialist

Summary

Verse Medical is a well-funded Series C company focused on improving healthcare delivery through innovative software solutions. They are seeking a detail-oriented RCM Enrollments Specialist to manage the enrollment operations for electronic data interchange, funds transfer, and remittance advice, ensuring seamless financial processes with a national network of payers.

Responsibilities

• Manage and execute the end-to-end enrollment process for EDI (Electronic Data Interchange), EFT (Electronic Funds Transfer), and ERA (Electronic Remittance Advice) for a national network of thousands of payers
• Proactively add and configure new payers to the system as the company expands its network and footprint
• Serve as the internal subject matter expert for clearinghouse operations and payer-specific enrollment requirements
• Investigate and resolve electronic connection issues, identifying root causes for transmission failures or 'missing' ERAs
• Audit existing payer connections regularly to ensure EFT/ERA setups are active and funds are being routed correctly
• Monitor the health of 270/271 (Eligibility) and 837/835 (Claims/Remittance) transaction loops to minimize manual intervention
• Coordinate with Payer Relations and Finance teams to ensure all enrollment data aligns with credentialing and banking requirements

Skills

• 3+ years of experience in Revenue Cycle Management, specifically focused on Enrollments or EDI Management
• Proven track record of managing enrollments across a large, national payer base (Commercial, Medicare, and Medicaid)
• Deep technical expertise in HIPAA standard transactions: 270/271, 837, and 835
• Proficiency with major clearinghouse platforms
• Strong proficiency in Excel for tracking high-volume enrollment statuses and project management
• Comprehensive understanding of payer-specific enrollment portals and paper-based enrollment requirements
• Familiarity with NPI, Tax ID, and PTAN configurations in relation to electronic billing
• Exceptional organizational skills with the ability to manage thousands of moving parts simultaneously
• Relentless follow-through, you don't stop until the connection is live
• Experience working within a DME (Durable Medical Equipment) environment is highly preferred

Qualifications

Must Haves

• 3+ years of experience in Revenue Cycle Management, specifically focused on Enrollments or EDI Management
• Proven track record of managing enrollments across a large, national payer base (Commercial, Medicare, and Medicaid)
• Deep technical expertise in HIPAA standard transactions: 270/271, 837, and 835
• Proficiency with major clearinghouse platforms
• Strong proficiency in Excel for tracking high-volume enrollment statuses and project management
• Comprehensive understanding of payer-specific enrollment portals and paper-based enrollment requirements
• Familiarity with NPI, Tax ID, and PTAN configurations in relation to electronic billing
• Exceptional organizational skills with the ability to manage thousands of moving parts simultaneously
• Relentless follow-through, you don't stop until the connection is live

Nice to Haves

• Experience working within a DME (Durable Medical Equipment) environment is highly preferred

Benefits

• We offer competitive benefits
• Professional development opportunities
• A culture that prioritizes work-life balance and continuous improvement