This is a Fully Remote Job
1. About Our Client:
This organization operates in the healthcare technology sector, focusing on enabling physicians across the country. It partners with medical groups, health plans, and health systems to optimize physician practices, enhance patient experiences, and support providers in delivering value-based care both in-person and virtually. Utilizing a cloud-based platform and scalable operations led by experienced industry and physician leadership, the organization aims to reduce unnecessary healthcare costs and improve health outcomes for patients and provider well-being.
2. About the Opportunity:
The
RCM Systems & Enrollment Analyst
plays a vital role in maintaining the integrity of revenue cycle management and provider credentialing data. The position drives process improvements and ensures accurate data across systems to prevent revenue loss. This role supports cross-functional teams by validating system configurations and managing enrollment processes to improve overall revenue cycle performance.
3. Responsibilities:
Complete EFT, ERA, EDI setup and enrollment with health plans through claims systems or payor portals under Senior Manager guidance.
Follow up regularly with health plans on provider submission statuses.
Address provider enrollment issues in collaboration with partners.
Identify and resolve revenue leakage through data analysis.
Ensure consistency of provider and practice data across EHR, credentialing, and payer systems.
Maintain and validate enrollment tables, matrices, and system configurations.
Review and optimize EHR rules to reduce credentialing and billing claim denials.
Collaborate across departments to resolve data and workflow issues.
Develop reports and dashboards tracking KPIs and revenue impact.
Document and share processes, system rules, and best practices.
Support special projects related to health plan requirements.
Coordinate and prepare reports.
Record and track credentialing statistics.
4. Requirements:
Bachelor''s degree in Healthcare Administration, Finance, Business, or related field preferred or equivalent experience.
Minimum of 3 years in managed care credentialing, billing, or medical staff service.
Strong problem-solving and analytical skills.
Advanced proficiency with Microsoft Excel.
Ability to work independently and manage multiple projects.
Compliance with HIPAA regulations.
Preferred knowledge of EFT, ERA, EDI enrollment, and claims systems.
Required Athena system knowledge and familiarity with Athena payer enrollment tables.
5. Pay Range and Compensation Package:
Base salary range of $55,000 to $60,000, exclusive of bonuses and benefits.
Eligible for an annual bonus targeted at 10%.
Base pay will be determined based on experience, education, and geographic location.
6. Benefits & Perks:
Medical insurance
Dental insurance
Vision insurance
401(k) retirement plan
Paid time off
Equal Opportunity Statement:
Equal Opportunity Statement:
Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.