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EDI Enrollments Specialist

Remote: 
Full Remote
Contract: 

Offer summary

Qualifications:

At least 2 years of experience in revenue cycle management, preferably in healthcare or healthtech., Experience with EDI enrollment is a plus, especially with Change Healthcare., Strong investigative mindset with the ability to analyze data and suggest actions., Excellent oral and written communication skills, along with effective multitasking abilities..

Key responsabilities:

  • Prepare and submit applications for EDI claims and Electronic Remittance Advice through various portals.
  • Investigate provider enrollment denials and errors with payers and take appropriate action.
  • Act as a liaison between the RCM department and Strategy & Operations team to resolve enrollment tasks.
  • Maintain accurate enrollment records and meet KPIs for production and quality.

Candid Health logo
Candid Health Startup https://www.joincandidhealth.com
11 - 50 Employees
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Job description

What You’ll Be Doing
  • 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 

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

  • You may have experience with EDI enrollment, Change Healthcare experience is a plus

  • 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.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Investigation
  • Multitasking
  • Teamwork
  • Communication
  • Problem Solving

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