EDI Enrollments Specialist

3 weeks ago


New York, United States Candid Health Full time

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 $25-$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.



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