Full-Time

Senior Enrollment Strategy Lead

Posted on 11/21/2024

Resmed

Resmed

5,001-10,000 employees

Develops cloud-connected medical devices for chronic diseases

Compensation Overview

$74k - $93kAnnually

Mid, Senior

Norcross, GA, USA

Category
Procurement & Sourcing
Quality Control & Compliance
Operations & Logistics
Required Skills
Salesforce
Requirements
  • Bachelor’s degree in healthcare administration, business, or a related field.
  • 3+ years of experience in payer enrollment, healthcare claims, commercial payers, and clearinghouse applications.
  • Strong understanding of payer policies, enrollment processes, and compliance regulations.
  • Excellent leadership and communication skills.
  • Strong analytical and problem-solving skills.
  • Detail-oriented with exceptional organizational abilities.
  • Experience with electronic enrollment systems and healthcare IT solutions.
  • Knowledge of healthcare reimbursement models and industry trends.
  • Expert knowledge of electronic insurance setups and processes.
  • Knowledge of accounts receivable and revenue cycle management.
  • Ability to work independently and make sound and timely decisions.
  • Excellent organizational, planning, and prioritization skills.
  • Demonstrated ability to consistently follow documented processes or task workflows.
  • Demonstrated ability to manage detailed tasks with accuracy and completeness.
  • Ability to multi-task and manage ongoing task priorities.
  • Advanced proficiency with Microsoft Office Suite Products.
  • Experience using a CRM software solution (Salesforce).
  • Experience with HME/DME software and providing customer service.
Responsibilities
  • Lead the payer enrollment process, ensuring timely and accurate submissions of applications and required documentation.
  • Communicate with healthcare providers to gather necessary documentation and information for enrollment or re-enrollment processes.
  • Process incoming Enrollment requests for Commercial/Government insurance plans for new and existing clients serving as liaison between the client and the clearinghouse.
  • Coordinate with clearinghouses to resolve any issues or discrepancies that arise during the enrollment process.
  • Identify and implement best practices to streamline enrollment processes with multiple clearing houses and reduce turnaround times.
  • Analyze enrollment data to identify trends, challenges, and opportunities and inform decision-making.
  • Work closely with internal teams and external stakeholders (e.g., payers) to resolve issues and improve enrollment outcomes.
  • Ensure accurate maintenance of enrollment documentation.
  • Complete deactivations of provider numbers, effective dates, NPI-related denials, NPI website, etc.
  • Manage and complete product/service activation requests by following configuration steps and setting appropriate feature settings in the Brightree operating system.
  • Respond to customer requests regarding system setup and activations.
  • Accurately document interactions with customers and vendors in Salesforce following standard processes.
  • Follow departmental procedures for case tracking and system updates.
  • Process customer and internal escalations per department guidelines.
  • Advise enrollment staff, providing training and guidance on enrollment processes.
  • Provide training and support on the enrollment process, documentation requirements, and the use of the enrollment portals.
  • Be the subject matter expert for the team for best practices, process and workflow definition, and documentation creation and maintenance related to enrolling with multiple clearinghouses.

ResMed develops medical devices and software platforms that help treat and manage conditions like sleep apnea and chronic obstructive pulmonary disease (COPD). Their products are cloud-connected, allowing for better monitoring and management of patients' health. ResMed's offerings include both medical devices and software subscriptions, which provide ongoing support and services. What sets ResMed apart from its competitors is its focus on reducing hospital visits and healthcare costs while improving the quality of life for patients. The company's goal is to enhance patient care and support healthcare professionals and caregivers in managing chronic diseases effectively.

Company Size

5,001-10,000

Company Stage

IPO

Headquarters

San Diego, California

Founded

1989

Simplify Jobs

Simplify's Take

What believers are saying

  • Growing sleep apnea market boosts demand for ResMed's products.
  • Telehealth adoption aligns with ResMed's cloud-connected device strategy.
  • AI integration in healthcare offers innovation opportunities for ResMed.

What critics are saying

  • Increased competition may impact ResMed's market share.
  • Rising raw material costs could squeeze profit margins.
  • Data privacy concerns may lead to regulatory scrutiny.

What makes Resmed unique

  • ResMed offers cloud-connected devices for sleep apnea and chronic disease management.
  • The company operates in over 120 countries, providing a global healthcare solution.
  • ResMed integrates AI in diagnostics, enhancing personalized treatment options.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Paid Vacation

Paid Holidays

Parental Leave

401(k) Retirement Plan

Employee Assistance Program (EAP)

Company News

MarketBeat
Feb 28th, 2025
Proficio Capital Partners LLC Invests $50.36 Million in ResMed Inc. (NYSE:RMD)

Proficio Capital Partners LLC invests $50.36 million in ResMed Inc. (NYSE:RMD).

Healthier Tomorrow
Feb 26th, 2025
ResMed Survey: Despite Sleep Problems, Few Willing to Take Proactive Steps

ResMed today unveiled the findings of its fifth annual Global Sleep Survey.

MarketBeat
Feb 22nd, 2025
Alberta Investment Management Corp Invests $2.38 Million in ResMed Inc. (NYSE:RMD)

Alberta Investment Management Corp invests $2.38 million in ResMed Inc. (NYSE:RMD).

India Med Today
Jan 10th, 2025
ResMed launches AirSense 11 for sleep apnea patients

ResMed launches airsense 11 for sleep apnea patients.

ResMed
Jan 6th, 2025
ResMed Announces Participation in the 43rd Annual J.P. Morgan Healthcare Conference

ResMed Announces Participation in the 43rd Annual J.P. Morgan Healthcare Conference

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