Managing the EDI Enrollment team is the core of this role, focusing on the timely and accurate setup, maintenance, and optimization of electronic data interchange (EDI), electronic remittance advice (ERA), electronic funds transfer (EFT), and related enrollments across various clearinghouses and payers. This position suits a leader with a strong background in healthcare revenue cycle management and a commitment to minimizing paper-based processes and accelerating revenue realization.
Responsibilities
Lead, mentor, and supervise the combined EDI Enrollment teams, including performance management, coaching, workload balancing across enrollment and mapping tasks, and career development
Oversee end-to-end processes: payer EDI/ERA/EFT enrollments/re-enrollments for new and expanding clients, ERA/EFT activations, address/pay-to changes, W9 submissions, and resolution of enrollment-related issues (e.g., missing ERA remits, claim rejections, failed transmissions)
Monitor enrollment statuses, pending approvals/signatures, remittance posting exceptions, and clearinghouse databases via Monday.com; maintain accurate tracking, dashboards, and regular status reviews
Coordinate and allocate resources flexibly across onboarding, post go-live and special projects for enrollment
Handle complex escalations and troubleshooting for enrollment failures, transmission issues, and other payer issues; drive root-cause resolution with internal teams, payers, and clearinghouses
Partner with Client Onboarding Lead and Revenue Cycle service delivery teams to execute work
Ensure compliance with payer requirements, documentation standards, and use of tools/templates
Provide regular status updates, KPI reporting (completion rates, rejection volumes, posting accuracy/automation metrics, process efficiency), and escalation summaries to leadership
Perform special projects, support audits/compliance efforts, and other duties as assigned
Requirements
Bachelor’s Degree preferred; High School Diploma/GED with equivalent experience required
5+ years of experience in healthcare revenue cycle management, with strong background in EDI/ERA/EFT enrollment, clearinghouse operations, etc
2+ years of supervisory or team lead experience in RCM/EDI/ ERA/EFT/ mapping functions
Hands-on experience with clearinghouses (Athenahealth, PhiCure, Imagine) and payer portals required
Familiarity with RCM software (Monday.com, MedSuite, Freshdesk, Smartsheet) and payer reimbursement/ERA posting workflows
Deep expertise in EDI/ERA/EFT enrollment processes, clearinghouse operations, and payer enrollment requirements
Proven supervisory skills: team leadership across technical functions, performance coaching, workload prioritization, and fostering accountability in a fast-paced, remote environment
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Strong analytical, problem-solving, and troubleshooting abilities for enrollment issues, transmission failures, mapping errors, and posting discrepancies
High attention to detail, organizational skills, and ability to manage multiple priorities under pressure
Excellent oral, written, and interpersonal communication skills; ability to explain technical EDI/mapping concepts to non-technical stakeholders
Proficiency in Microsoft Office Suite (Excel for tracking/reports), database tools, and RCM platforms
Knowledge of medical terminology, coding concepts, and payer reimbursement processes a plus
Initiative-driven with sound judgment; handles sensitive/confidential information appropriately
Flexibility, collaboration, and strong alignment with Ventra Health values (excellence, accountability, teamwork, growth, transparency, inclusiveness, recognition, compliance)
Benefits
Eligible for Ventra performance-based incentive plan
Discretionary incentive bonus in accordance with company policies
Referral bonus for referring a friend
About the Company
Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.
