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Verse Medical

RCM Enrollments Specialist

Reposted 20 Days Ago
Remote
Hiring Remotely in USA
Mid level
Remote
Hiring Remotely in USA
Mid level
The RCM Enrollments Specialist manages the enrollment process for EDI, EFT, and ERA, ensuring smooth operations with payers, resolving issues, and auditing connections within a DME environment.
The summary above was generated by AI
Our Mission: Hospital-Quality Care, Everywhere.

The healthcare industry still relies on faxes and phone tags to coordinate critical care for patients at home. We think patients and the clinicians who serve them deserve better than a system stuck in 1995.

Verse Medical is building the modern software infrastructure to make it happen. We're a well-funded Series C company (backed by General Catalyst, SignalFire, and Sapphire Ventures) on a mission to heal a fragmented system. Our platform connects the dots between providers, payors, and patients, ensuring people get the high-quality care they need, reliably and right where they live. We’re growing fast and looking for people who are driven by this mission to join us!

Our Values: The Principles That Guide Us

Our values are the operating system for how we work together and with our partners. They aren't just words on a wall; they are the principles we bring to every decision, every day.

  • We are transparent, upfront and direct. We operate with honesty and clarity. We share information openly, the good and the bad, and believe that direct, respectful feedback is the foundation of trust and progress.

  • We value speed of iteration. We are building something new, which means we learn by doing. We prioritize rapid iteration and getting solutions into the hands of users, believing that progress is more valuable than perfection.

  • We give 110% effort, 30% of the time. We are passionate about our mission, and there are moments that require us to go the extra mile. We believe in focused intensity when it counts, balanced by a sustainable pace that keeps our team energized for the long run.

  • We empathize with customers to a fault. When our users face a problem, we own it. Instead of asking them to change, we ask ourselves, "How can we make this better?" We believe true innovation comes from deep empathy and a relentless focus on solving the real-world challenges of healthcare.

The Opportunity

We are seeking a highly detail-oriented and technical RCM Enrollments Specialist to lead our national enrollment operations. As a DME provider operating across the country and partnering with thousands of payers, maintaining seamless electronic connections is vital to our financial health. You will be the primary owner of our EDI, EFT, and ERA enrollment lifecycle, ensuring that as we scale our network, our ability to verify eligibility, submit claims, and receive payments remains uninterrupted and optimized.

What You’ll Do
  • 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.

What You’ll Bring

Experience

  • 3+ years of experience in Revenue Cycle Management, specifically focused on Enrollments or EDI Management.

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

  • Proven track record of managing enrollments across a large, national payer base (Commercial, Medicare, and Medicaid).

Technical Skills

  • 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.

Industry Knowledge

  • 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.

Soft Skills

  • 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.

The People You’ll Work With

You will report to the RCM Director and work closely with the Billing Team, Payer Relations, and Engineering. As the "bridge" between our company and our payers, you will play a foundational role in ensuring our revenue cycle operations run smoothly as we grow.

Life at the Company

We foster a collaborative and innovative environment where every team member's contribution is valued. We offer competitive benefits, professional development opportunities, and a culture that prioritizes work-life balance and continuous improvement.

Our Pledge for an Equitable Future

At Verse Medical, our mission is to deliver equitable, hospital-quality care to everyone, regardless of their background or where they live. We can only achieve this if our own team reflects the diversity of the patients we serve. We are committed to building a workplace where everyone feels a sense of belonging, where their contributions are valued, and where they can do their best work. We embrace diversity of all kinds: race, gender, age, religion, identity, experience. We are actively working to build a more inclusive and equitable world, starting from within our own walls. We are an equal opportunity employer.

We are also committed to providing a positive and accessible interview experience. If you require any accommodations to participate in our process, please contact us at [email protected].

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