Employer Industry: Healthcare Management Services

Why consider this job opportunity:
- Competitive salary with a comprehensive Total Rewards package
- Opportunity for career advancement and growth within the organization
- Remote work flexibility available, with occasional in-person meetings in California
- Comprehensive benefits, including medical, dental, and vision plans, Health Spending Account, and a generous 401k match
- Supportive work environment focused on quality patient care and operational excellence
- Chance to work with industry-leading technology and integrated systems

What to Expect (Job Responsibilities):
- Oversee daily operations of EDI systems and provide support for all EDI-related inquiries
- Manage vendor relationships and operational metrics for EDI transactions
- Create and integrate EDI maps and processes, providing analytical support and implementation
- Handle claims processing over EDI, including oversight of clearinghouse relationships
- Perform data audits and quality control measures to ensure compliance and accuracy

What is Required (Qualifications):
- BS/BA degree or equivalent work experience
- Knowledge of EDI standard formats (ANSI X12) and TSQL experience
- Strong ethical standards and integrity
- Excellent judgment and decision-making abilities with a customer-focused approach
- Demonstrated ability to identify root issues and resolve problems effectively

How to Stand Out (Preferred Qualifications):
- Broad understanding of healthcare insurance and claims processing
- Experience with healthcare-related EDI transactions
- In-depth knowledge of EZCAP and related modules
- Ability to train and mentor junior staff on EDI processes
- Experience with encounter data validation and reconciliation

#HealthcareManagement #EDISpecialist #RemoteWork #CareerGrowth #HealthcareInsurance

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