Enrollment Strategy & Operations

About the role

We’re building a new healthcare clearinghouse. In the healthcare sector, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that all insurance payers exchange transactions such as claims, eligibility checks, prior authorizations, and remittances using a standardized EDI format called X12 HIPAA. Clearinghouses process the majority of these transactions, offering consolidated connectivity to carriers and providers. Until Stedi, the space was occupied entirely by a small group of legacy players, built on outdated, often pre-internet technology. Stedi is the world's only programmable healthcare clearinghouse. By offering modern API interfaces alongside traditional real-time and batch EDI processes, we enable both healthcare technology businesses and established players to exchange mission-critical transactions. Our clearinghouse product and customer-first approach have set us apart. Stedi was ranked by Ramp as one of the fastest-growing SaaS vendors. We have lightning in a bottle: engineers and designers shipping products week in and week out; a lean business team supporting the company’s infrastructure; passion for automation and eliminating toil; $142 million in funding from top investors like Stripe, Addition, USV, Bloomberg Beta, First Round Capital, and more.

Stedi is an API-first healthcare clearinghouse. By offering a modern API interface for running eligibility checks, processing claims, and ingesting ERAs, healthcare technology businesses are able to exchange transactions with payers without dealing with the EDI protocol or carrier-specific connectivity. Transaction enrollment is the process of registering a provider with a payer to exchange specific healthcare transactions. It involves submitting information about the provider, including their name, tax ID, NPI, billing address, and contact information. Transaction enrollment is the most toilsome process that revenue cycle businesses and teams have to manage. Thousands of payers, each with their own quirky enrollment experience. Form fills, faxes, PDFs, wet signature, and provider portal all stand in the way of reconciling financials and processing transactions.

Responsibilities

• Contribute and scale the day-to-day operation of Stedi’s transaction enrollment program.
• Establish and continuously improve Stedi’s enrollment playbook across thousands of payers that supports a growing percentage of the country’s provider base.
• Interface with customers, intermediary clearinghouses, and payers on a daily basis in order to get enrollments approved, improve the systems, and scale the operation.
• Create and grow a content management system of payer-specific enrollment steps and feed those steps back into the product and system that you operate.
• Collaborate with product to define and ship requirements to improve the enrollments product, both the external version and internal tooling that supports.
• Measure the performance of your system by defining metrics, and driving those metrics to levels not achieved by other clearinghouses.
• Troubleshoot enrollment issues, solve root causes, and manage customer-related escalations relating to missing ERAs.

Who You Are

• You have experience building operational processes and programs. You’ve seen where systems break down, where bottlenecks emerge, and are excited to come in every day and improve the system.
• You understand the benefits of compounding small incremental gains.
• You are exceptional at staying on top of many open threads simultaneously. You are hyper-responsive, organized, and thorough. You almost never drop balls.
• You have a technical background. You love building automations, workflows, and using AI to support end-to-end automation. You might not be a software developer, but you know how to use tools to improve systems and eliminate toil.
• You have experience in externally facing roles: You have experience in client-facing roles; ideally within consulting, support, implementation and onboarding, or program management.
• You have a systems mindset. You go beyond helping with the task at hand. You are able to intuitively understand gaps as you work through implementations and are able to articulate those to the product, payer operations, and engineering team.
• You do what it takes to get the job done. You are resourceful, self-motivating, self-disciplined, and don’t wait to be told what to do. You put in the hours. You move quickly.