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Edi Enrollment Specialist (Experienced)

Ventra Health
Ventra health
2-5 years
preferred by company
Hyderabad
1 May 12, 2026
Job Description
Job Type: Full Time Hybrid Education: M.Pharm/B.Pharm or M.Sc. Skills: ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology

EDI Enrollment Specialist (Experienced)

Job Category: Healthcare Operations / Revenue Cycle Management
Department: Client Onboarding / EDI Enrollment
Location: Hyderabad, India
Work Mode: Hybrid
Employment Type: Full-Time
Shift: Night Shift / NGT
Experience Required: Experienced Professionals Only (Freshers Not Eligible)

About the Role

A leading healthcare revenue cycle management organization is seeking an experienced EDI Enrollment Specialist to join its client onboarding and healthcare operations team in Hyderabad. This role is ideal for professionals with expertise in electronic data interchange (EDI), ERA enrollment, EFT setup, clearinghouse operations, healthcare billing workflows, and revenue cycle support.

The selected candidate will be responsible for managing provider and facility enrollments, ensuring successful electronic claims submission, resolving payment workflow issues, and supporting payer connectivity processes for healthcare reimbursement operations.

This opportunity is ideal for professionals looking to build their career in healthcare revenue cycle management, EDI operations, healthcare billing technology, claims processing, and client onboarding services.

Key Responsibilities

  • Set up and manage provider and facility enrollments in healthcare clearinghouse systems.
  • Process EDI enrollments to enable electronic healthcare claims submission.
  • Manage ERA (Electronic Remittance Advice) enrollment to transition from paper remittance workflows.
  • Handle EFT (Electronic Funds Transfer) enrollments for direct payment processing.
  • Verify successful claim transmission, ERA setup, and EFT activation across payer networks.
  • Track enrollment progress and monitor pending approvals, payer responses, and required documentation.
  • Research and confirm successful file transmissions between healthcare providers, clearinghouses, and payers.
  • Troubleshoot failed claim transmissions, EDI rejections, payment discrepancies, and enrollment-related issues.
  • Resolve escalations involving missing remittances, unexpected paper payments, or incorrect reimbursement workflows.
  • Collaborate with internal operations, billing, and client onboarding teams to resolve complex issues.
  • Support operational improvement initiatives and additional healthcare technology projects as assigned.

Required Qualifications

  • High School Diploma, GED, or equivalent qualification
  • Professional experience in:
    • Healthcare access administration
    • Medical billing operations
    • Healthcare IT support
    • Revenue cycle management
  • Strong understanding of:
    • EDI enrollment workflows
    • ERA setup and remittance processing
    • EFT enrollment procedures
    • Healthcare clearinghouse systems
    • Electronic claims submission processes

Preferred Skills

Candidates with the following expertise will be highly preferred:

  • Experience working with healthcare clearinghouse platforms such as:
    • Athena
    • PhiCure
  • Strong troubleshooting and problem-solving skills
  • Excellent written, verbal, and interpersonal communication abilities
  • Strong organizational and time management skills
  • Proficiency in:
    • Spreadsheet tools
    • Database systems
    • Presentation software
    • Word processing applications
  • Ability to communicate technical workflows to both technical and non-technical stakeholders
  • Strong decision-making skills with the ability to work independently
  • Ability to manage confidential healthcare information responsibly
  • Comfortable working in fast-paced healthcare operations environments