EDI Enrollment Specialist; Medical Billing

Rethink Behavioral Health is the leading global provider of online research-based resources to support individuals with developmental disabilities. Our behavioral health platform () provides clinical, staff training and practice management tools for private ABA service providers. Due to autism insurance mandates sweeping the nation, our behavioral health division is experiencing unprecedented growth. Therefore, we are looking for the right person to join our billing service team.

Our office specializes in Revenue Recycle Management, as well as Enrollment and Credentialing Services, for behavioral health providers. We support mission-oriented companies that impact the lives of thousands of individuals with autism and their families. We are excited to offer the opportunity for professional and collaborative individuals to be a part of a growth-oriented business.

As an EDI Enrollment Specialist, you will be responsible for Government and Commercial payer enrollment. This position covers initial enrollment for new payers with the clearinghouse, CAQH application monitoring services as well as revalidation enrollment when needed. You will be working directly with providers and the clearinghouse (Waystar, Availity, Steadi etc.), insurance representatives, CAQH and our clients for enrollments as well as troubleshooting any enrollment issues that arise.

• Responsible for electronic data interchange (EDI) processes related to Behavioral Health/Medical billing enrollment ensuring the accuracy of data during the submission process.
• Prepare and submit applications to configure Electronic Data Interchange (EDI) claims and Electronic Remittance Advice (ERA) through clearinghouse and other payer portals.
• Prepare and submit applications to configure Electronic Funds Transfer (EFT) with payers.
• Review all payments being received to identify all payers that EDI, ERA and EFT can be processed through our clearinghouse.
• Communicate with our clearinghouse on any enrollment issues.
• Review provider enrollment denials and errors with payers to resolve denial issue in a timely manner, working directly with the payers and providers.
• Partner with the Billing Implementation team and Director, RCM Operations to enroll new payers/providers to resolve enrollment tasks.
• Maintain accurate enrollment records and provide updates to Management and Clients as needed.
• Document and maintain process workflows, systems configuration, and tools used in the department.
• Adhere to and follow all HIPAA guidelines.
• Be assigned special projects as needed.

• At least 2 years of experience in revenue cycle management (for medical billing or behavioral health billing).
• Experience with EDI enrollment including the enrollment of payers with clearing houses such as Availity, Waystar and Stedi.
• Familiarity with EDI file formats (such as 834 transactions) and experience with EDI software and systems are essential.
• Experience with Credential Stream is a plus.
• Self-starter comfortable working with Clients and Vendors to resolve issues in a timely manner.
• Excellent oral and written communication skills.
• Effective at multitasking and can demonstrate the ability to work with multiple clients at the same time.
• Ability to communicate with individuals at all levels of the organization.

• Paid Time Off and Vacation Days after a 90-day introductory period.
• Paid Holidays.
• Generous Health, Dental & Vision benefits package.
• 401(k) + Matching.

Full-time, Monday-Friday (8-5 PM).

AL, AR, AZ, CA, CO, FL, GA, , IL, IN, IA, MO, NC, NE, NY, OH, PA, SC, TN, TX, UT, VA.

Rethink First is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because that is what drives curiosity, innovation, and the success of our business. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate.

Accommodations are available for applicants with disabilities.