Electronic Data Interchange Coordinator- Hybrid (RI)

Summary

We are seeking an enthusiastic and motivated individual to optimize the company’s Electronic Data Interchange (EDI) processes. The ideal candidate demonstrates a proactive and positive attitude, with a strong passion for continuous improvement. 

Under minimal supervision, they can perform routine to complex tasks that are related to various healthcare claims and transactions.  Provide training to the provider community and work as a liaison with our customer to implement programs that are necessary for the Medicaid program.  Apply knowledge of established policies and procedures to resolve provider issues and work with our customer to ensure we are compliant. Exercise independent judgment within defined practices and procedures to determine appropriate action. Evaluates unique circumstances and makes recommendations.  

Your role in our mission

• Conduct in-person or virtual visits to provider offices to install software and train providers on its use in compliance with service requirements.

• Troubleshoot inbound and outbound HIPAA-compliant files to ensure accuracy, compliance, and acceptance.

• Provide customer service support through the help desk.

• Update and manage online EDI enrollments.

• Serve as a subject matter expert on EDI enrollments, offering guidance and expertise.

• Research and resolve errors identified by trading partners related to ERA/EFT.

• Take the lead in areas of EDI expertise to support business goals.

• Maintain knowledge of industry standards for electronic claim file exchanges.

What we're looking for

• College Graduate or Healthcare or insurance experience helpful.  HIPAA standard transaction experience beneficial. Demonstrates strong analytical skills and customer relations skills.

• Experience in billing medical claims within a provider office setting.

• Ability to apply previously learned knowledge and skills to new and evolving situations.

• Strong customer service orientation with proven problem-solving, decision-making, and analytical abilities.

• Ability to function as a technical resource between providers and the provider representative team.

What you should expect in this role

• Strong oral and written communication skills.

• Self-motivated with excellent time management and organizational abilities; able to work independently and collaboratively as part of a team.

• Skilled at prioritizing and managing multiple tasks under tight deadlines.

• The role will be 8am-5pm M-F. It will be Hybrid, but more in office during training.

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