tango · 14 hours ago
EDI Operations Specialist
United States
Full-time
Remote
Mid Level
3+ years exptango is a leader in the home health management industry, preparing for significant growth. The EDI Operations Specialist will manage the technical and administrative lifecycle of claims data, focusing on EDI transactions and serving as a liaison between the Claims team, IT, and external trading partners.
AnalyticsHealth CareHome Health Care
Responsibilities
Manage the end-to-end lifecycle of EDI transactions (834/835/837), including file programming, validation, output, and error resolution
Serve as the primary liaison for trading partners, clearinghouses, payers, and vendors to troubleshoot transmission failures and rejection codes
Manage file generation and uploads and ensure compliance with x12 formatting standards
Research, analyze, and resolve data discrepancies between output files and source systems
Validate file layouts and mappings, against companion guide requirements
Ensure strict compliance with HIPAA x12 standards, CMS guidelines, and internal data policies
Lead testing and validation for new trading partner implementations or system upgrades
Document business requirements for implementations, system enhancements, or new trading partners
Monitor post-go-live implementations for data accuracy and coordinate required corrections
Develop and maintain comprehensive desktop procedures, job aids, and EOP insert revisions for new or changed processes
Develop testing schedules and accountabilities, documenting results and lessons learned
Perform time studies within the claims department to identify bottlenecks and document process steps
Act as the liaison between Reporting/Data Analytics and Claims Management to drive reporting enhancements
Maintain and distribute Claims Dashboards (Trends/Patterns) by the 5th of the month
Develop and maintain GURU Claims Dashboard and Cards; generate reporting on usage and ROI
Oversee Symkey Daily Robot Checks and monitor automation performance
Train Claims Staff on Standard Policies and Procedures regarding data handling
Maintain Desktop Procedures for Payor Audits
Distribute operational reports to internal and external stakeholders
Qualification
Required
Associate's or bachelor's degree in healthcare administration, Information Technology, or related field preferred (or equivalent technical experience)
3+ years of EDI experience specifically with 834 (Enrollment), 835 (Remittance), or 837 (Claim) transactions required
3-5 years Medicare/Medicaid claims experience required
Advanced proficiency in Microsoft Excel (VLOOKUP's, pivots)
Proficiency of SQL and database querying
Excellent data analysis skills with the ability to review data to identify trends, anomalies, and opportunities
Excellent oral and written communication skills; capable of explaining technical issues to non-technical stakeholders
Highly self-motivated and capable of working independently to follow issues through to conclusion
Detail-oriented with the ability to prioritize tasks in a fast-paced environment
Ability to maintain a high level of confidentiality and remain HIPAA compliant
Ability to multitask in a fast-paced work environment
Ability to remain calm under pressure and manage stressful situations
Ability to establish highly productive and detailed organizational skills/habits
Ability to actively listen and solve problems with cooperation, assertiveness, and flexibility for positive outcomes
Possess strong, professional written and oral communication skills for in-person, telephonic, and electronic use
Company
tango
tango is a post-acute management services company that provides home healthcare services.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Brian Lobley
Chief Executive Officer
David Wilkinson
Chief Financial Officer
Recent News
2025-10-01
2025-08-05
Company data provided by crunchbase