EDI Enrollments Specialist

2 weeks ago

San Francisco, 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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