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EDI Enrollments Specialist

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 $22-$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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