EDI Enrollments Specialist

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 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 https://www.pave.com/ data, and the actual base salary may be modified based on factors including job-related skills, experience/qualifications, interview performance, market data, etc.