EDI Enrollments Specialist

Candid Health

4d•$22 - $27

About The Position

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

Requirements

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

Nice To Haves

You may have experience with submitting and troubleshooting EDI enrollments

Responsibilities

Prepare and submit applications to configure Electronic Data Interchange (EDI) claims and Electronic Remittance Advice (ERA) through clearinghouse and other payer portals
Prepare and submit applications to configure Electronic Funds Transfer (EFT) with payers
Initiate investigation with payers regarding provider enrollment denials and errors
Review correspondence received from payers and action appropriately for resolution
Work as a liaison between the RCM department and Strategy & Operations team to discuss, investigate, and resolve enrollment tasks
Interact with our customers through excellent written and verbal communication
Maintain up-to-date and accurate enrollment records within the Candid Health product
Meet and maintain KPIs/metrics for production and quality
Maintain working knowledge of workflow, systems, and tools used in the department
Maintain HIPAA guidelines