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EDI Coordinator

4 months ago

Concord, United States EDI Staffing Full time

The EDI Coordinator provides accurate, secure, and expedited enrollment for employer groups and Third-Party Administrators (TPAs).

Responsibilities:

  • Promotes accurate electronic file EDI feeds by educating and training employer groups and TPAs about file formatting and requirements.
  • Implements electronic group enrollments by receiving and entering eligibility records into the custom enterprise system. Updates current records as needed.
  • Reviews enrollment data for accuracy by comparing and analyzing error reports and performing audits. Collaborates with TPAs and employer groups to reconcile discrepancies and update records.
  • Improves claims adjudication by performing scenario testing, researching errors, and updating enrollment data in the custom enterprise system.
  • Provides excellent customer service to employer groups by processing electronic eligibility files accurately and in a timely fashion; answering calls, and responding to email inquiries.
  • Provides training, guidance, and information on electronic enrollment by maintaining and enhancing knowledge about the process and rules around setting up and receiving EDI 834 transactions, electronic enrollment files, the subscriber benefit administration tool, and eligibility modules in the custom enterprise system.
  • Maintains accurate process and procedure reference guides by documenting, reviewing, and updating department manuals, training materials, and related documentation.
Experience:
  • 2+ years of EDI or enrollment experience
  • Must be proficient in the use of the Microsoft Office suite.
  • Experience with online enrollment tools, electronic enrollment file formats, and the Health Insurance Marketplace preferred.
  • Excellent communication skills