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Electronic Data Interchange Specialist
1 month ago
Our fast growing healthcare client in Phoenix, AZ is seeking a Data Provider Enrollment Specialist to join their team as a full time employee. The Specialist sets up, maintains, and supports the EDI processes to include business analysis, configuration, coding, peer and quality assurance testing, and final documentation. This person will also apply professional experience, including analysis, process design, modification, configuration, data mapping and maintenance of application programs, integrated systems, and software solutions.
MUST:
- Bachelors degree (ideally healthcare related)
- MUST have experience with SQL reports (Can pull data and write reports into SQL experience (the certification for SQL preferred)
- Experience or knowledge of a claims clearing house
- Ability to mange 3 people
- Experience managing tables, authorized to add payors to the systems, manage the backend part of the system.
- Understanding of healthcare Billing applications
- Has added new providers into tables within the software (they use waystar)
- In depth knowledge of EDI standards for healthcare (i.e. HIPPA and ACA, X12, ANSI standards, 837 and 835 reimbursement, 270 and 271 claims standards)
- Technical ability related to payor enrollment, Knowledge of healthcare reimbursement, Payor policies and regulatory requirements
Plus:
- Has worked with software such as: Zoll or Tritech
- Has worked with the billing software called centricity EDI (which has a clearing house module called EDI, but moving to waystar)
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