IN SUMMARY...
The RCM Success EDI Specialist is responsible for implementing and maintaining clearinghouse connectivity for the Azalea Health Revenue Cycle Management Department and operates under the direct supervision of the Senior Manager of RCM Success.
WHAT YOU WILL DO...
- Acts as the RCM EDI Enrollment SME in all areas of the process, including and not limited to clearinghouse portals and troubleshooting issues.
- Trains RCM team members in the EDI Process and Azalea RCM Specific SOPs
- Supports the development of Standard Operating Procedures (SOPs) in collaboration with the RCM Operations Leadership
- Maintains and consistently strives for 95% EDI Enrollment Rate
- Maintains and consistently strives for 95% ERA Enrollment Rate
- Responsible for implementing and onboarding new RCM client clearinghouse functions
- Responsible for reviewing and maintaining clearinghouse functions for all Azalea RCM current clients
- Develop and maintain all areas of clearinghouse functions including, but not limited to: 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
- Communicates and records trends, analysis, areas of improvement to RCM employees and management
- Responsible for overseeing payer website access and direct enrollments
- Performs Quality Assurance tasks and review on accounts when requested
- Maintains HIPAA compliance when handling patient protected health information (PHI)
- Effectively monitors and audits clearinghouse enrollments for all RCM clients
- Maintain excellent relationships with 3rd party vendors and clients
- Responsible for other Revenue Cycle Management-related duties, as assigned
BACKGROUND AND SKILLS YOU WILL BRING...
- Excellent ICD-10, CPT, and HCPCS coding knowledge & skills
- Minimum 2 to 3 years experience in Revenue Cycle Management or healthcare administration required
- Excellent computer and internet skills/instincts
- 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
SUCCESS LOOKS LIKE...
- Being aggressive and taking initiative; we trust you to move the needle forward
- Doing the job; outcomes are just as important as strategy
- Being adaptable and amenable to meet the changes of a dynamic and evolving industry
- Demonstrating humility; partnership and collaboration is who we are and how we operate
- Tapping into your innovative side; conventional is not always correct
HOW WE INVEST IN YOU...
- Competitive and comprehensive benefits: Coverage options to support the whole person, 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: Simple Paid Time Off (PTO) options. You earn your time, use it as you choose.
- Economic opportunity: Competitive total rewards package that offers competitive pay and advancement opportunities
Azalea Health's EEO Statement
Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.