EDI Payer Services Specialist

4 weeks ago


Remote, Oregon, United States Zotec Partners Full time

We're seeking an EDI Payer Services Specialist to join us.

What you'll do:

  • Monitor business processes to ensure service level agreements are met
  • Interact with new and current trading partners to capture and analyze requirements, mapping specifications and project objectives
  • Investigate issues related to vendor files
  • Respond with appropriate urgency when process variations are discovered
  • Communicate with outside agencies, carriers or facilities as research requires to gather information to resolve issues
  • Troubleshoot to ensure different file formats load into Zotec system
  • Act as an ambassador for Zotec's purpose, initiatives and goals

What you'll bring to Zotec:

  • Knowledge of HIPAA/EDI X12 v5010 healthcare-related file formats with advanced experience working with 270 and 271 files
  • Experience in healthcare business processes, claims and enrollment
  • Knowledge of industry standard health data code sets such as ICD-10, CPT/HCPCS, and Revenue Codes
  • Conceptual understanding of the .NET framework or experience working in a .NET environment
  • Working knowledge of XML
  • Proficient with Microsoft Office software including Outlook, Word, Excel, and Access
  • Strong analytical, problem solving, organizational and priority management skills
  • Strong verbal and written communication skills, both technical and non-technical
  • Ability to work independently, be self-motivated and have the willingness and ability to lead small initiatives and projects
  • Must be able to multi-task, be flexible and embrace change


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