Enrollment Specialist

The Enrollment Specialist is responsible for managing the enrollment process for healthcare providers with insurance payers. This includes completing and submitting enrollment applications, facilitating Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) setups, tracking application statuses, and ensuring compliance with payer requirements. The role is critical in supporting accurate billing, smooth claim processing, and timely reimbursement.

Key Responsibilities:

Enrollment & Credentialing

Complete and submit provider enrollment applications to commercial and government payers (e.g., Medicare, Medicaid, UHC).
Maintain accurate and up-to-date provider profiles in internal systems and payer portals.
Manage CAQH profiles, re-attestations, and credentialing documents.

EFT/ERA Setup

Coordinate Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) enrollment with payers.
Verify banking information and obtain Electronic Funds Authorization from providers.
Ensure successful linkage of ERA files to billing software or clearinghouse.

Data Management & Tracking

Track enrollment status across multiple payers and follow up regularly.
Maintain internal logs and dashboards for reporting purposes.
Ensure all payer communication and confirmations are documented properly.

Communication

Serve as a liaison between providers, the billing team, and insurance companies.
Respond to payer requests for additional documentation or clarification.
Support credentialing audits and re-enrollment processes.

Compliance & Accuracy

Ensure that all submissions comply with HIPAA, payer guidelines, and organizational policies.

Skills

MS Excel EDI ERA EFT Fluent in English

Job Details

Industry:

BPO

Functional Area:

Client Services & Customer Support

Total Positions:

1 Post

Job Shift:

First Shift (Day)

Job Type:

Full Time/Permanent

Job Location:

Lahore, Pakistan

Gender:

No Preference

Minimum Education:

Bachelors

Career Level:

Entry Level

Minimum Experience:

1 Year

Apply Before:

Jun 28, 2025

Posting Date:

May 29, 2025

Cyber System (Pvt) Ltd

BPO · 101-200 employees - Lahore

Cyber System is a US based organisation, established in 2008, is a leader in customized outsource Software development, Medical Billing, Recruitment solutions, research and human resource services representing clients throughout the world. The core philosophy behind Cyber System is to tackle the business problems and create novel and efficient solutions by utilizing state-of-the-art technology. Cyber System believes in professionalism, business ethics and morality. It aims at long-term relationships based on trust, understanding and good will. Business criteria at Cyber System are many as opposed to profit alone. Here, commitment, sincerity and enthusiasm form the path to professionalism. Effective and regular communication and sanctity of timelines is very important to Cyber System. This leads to the satisfaction of both the Cyber System Team and Cyber System Clients. Aspiring to expand to new sectors, Cyber System aims at rendering its services to many new markets both national and international.