Enrollment & Billing Specialist

Company Overview

ResPro Health is dedicated to providing our partners in the respiratory space with the tools and resources needed to implement meaningful programs like remote patient monitoring and chronic care management in their pulmonary practices. With a focus on quality patient care and innovative solutions, ResPro Health equips specialists with dedicated staff to improve patient outcomes, promote patient engagement and support therapy compliance. 

Position Overview:
We are seeking a detail-oriented and proactive Enrollment & Billing Specialist to support enrollment and billing operations for our Care Management programs. This multifaceted role requires strong organizational skills, discretion, and the ability to manage multiple priorities across teams. This role is responsible for managing the end-to-end billing cycle across multiple EMR systems, ensuring timely and accurate claim submission, payment tracking, denial resolution, and client/patient support. The ideal candidate will have strong analytical skills and a deep understanding of billing and insurance trends.

Key Responsibilities

Enrollment

• Patient Outreach & Education: 
• Initiate calls to eligible patients, clearly explaining the benefits of our care programs for managing chronic conditions and improving overall health.
• Assist the care team with patient communication.
• Eligibility Verification: 
• Confirm patient eligibility and verify insurance coverage.
• Data Entry & Management: 
• Maintain accurate and up-to-date records of patient interactions and maintain documentation to support the integrity of the patient’s chart.
• Team Collaboration: 
• Work closely with internal teams and healthcare providers to ensure seamless coordination and support.
• Performance Goals: 
• Consistently meet or exceed established enrollment targets.

Billing

• Claim Submission:
• Assist with claim drop in multiple EMR systems, ensuring compliance with payer requirements and program- specific billing rules.
• Ensure all monthly reports are uploaded in each client EMR
• Payment Tracking:
• Pull and analyze payment reports to monitor reimbursement trends and identify discrepancies.
• Denial Management:
• Investigate and follow up on denied claims, coordinating with client’s billing team to resolve issues
• Client & Patient Support
• Respond to client billing inquiries with professionalism and clarity.
• Answer patient billing questions, providing guidance on statements, insurance coverage, and coordination with client on payment options.
• Billing Analysis & Reporting:
• Conduct regular analysis of billing and insurance trends to identify opportunities for process improvement.
• Provide billing insights and analysis to leadership to drive enrollment campaigns.
• Compliance & Updates:
• Stay current with billing regulations and payer updates relevant to care management programs.
• Communicate billing changes and updates to the leadership team in a timely manner.
• Additional Responsibilities (if requested):
• Special Projects
• RePro Sleep appointment and follow up in Tebra

Requirements

• Prior experience in a Healthcare setting is preferred
• Proficiency with basic computer applications and data entry
• Strong problem-solving skills and ability to multitask effectively
• Excellent verbal and written communication skills
• Collaborative team player with a positive attitude
• Ability to work independently in a remote environment
• Successful completion of a background check
• Strong understanding of medical billing, coding, and insurance processes.
• Proficiency in Excel and billing software tools.
• Analytical mindset with attention to detail.

Benefits

Flexible Paid Time Off 

Training and Development opportunities 

Compensation: $20 - $22 per hour (Part-Time, Hourly, Non-Exempt)