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Candid Health · 3 hours ago

EDI Enrollments Specialist

United States

Contract

Remote

Entry, Mid Level

$22/hr - $27/hr

2+ years exp

Candid Health is a company focused on healthcare solutions, and they are seeking an EDI Enrollments Specialist. The role involves preparing and submitting applications for Electronic Data Interchange claims, investigating enrollment denials, and maintaining accurate enrollment records while ensuring compliance with HIPAA guidelines.

Artificial Intelligence (AI)BillingHealth CareSoftwareTransaction Processing

Responsibilities

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

Qualification

EDI enrollmentRevenue cycle managementChange HealthcareHIPAA complianceMultitasking skillsInvestigative mindsetCommunication skillsSelf-starter

Required

You have at least 2 year of experience in revenue cycle management (for medical billing or within healthcare/healthtech)

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