EDI Enrollments Specialist

Job Responsibilities

You'll prepare and submit applications to configure Electronic Data Interchange (EDI) claims and Electronic Remittance Advice (ERA) through clearinghouse and other payer portals

You'll prepare and submit applications to configure Electronic Funds Transfer (EFT) with payers

You'll initiate investigation with payers regarding provider enrollment denials and errors

You'll review correspondence received from payers and action appropriately for resolution

You'll work as a liaison between the RCM department and Strategy & Operations team to discuss, investigate, and resolve enrollment tasks

You'll interact with our customers through excellent written and verbal communication

You'll maintain up-to-date and accurate enrollment records within the Candid Health product

You'll meet and maintain KPIs/metrics for production and quality

You'll maintain working knowledge of workflow, systems, and tools used in the department

You'll maintain HIPAA guidelines

Qualifications

You have at least 2 year of experience in revenue cycle management (for medical billing or within healthcare/healthtech)

You may have experience with submitting and troubleshooting EDI enrollments

You have an investigative mindset and you are comfortable running down problems and suggesting actions based on data

You are a self starter

You take pride in your craft and enjoy maintaining a high quality bar, but also believe that "done is better than perfect" and have good intuition around which corners are okay to cut and which aren't.

You have excellent oral and written communication skills

You have effective multitasking skills

You have a positive and cooperative attitude in working and communicating with individuals at all levels of the organization

Pay Transparency

The estimated starting annual salary range for this position is $22-$27 USD per hour. The listed range is a guideline from Pave data, and the actual base salary may be modified based on factors including job-related skills, experience/qualifications, interview performance, market data, etc.