Job description

General Summary

The EDI Coordinator is responsible for the submission of all outbound EDI (ANSI-X12) files to trading partners. The coordinator generates and monitors EDI outbound transactions between IDMSO and trading partners. The coordinator is responsible for reconciling submissions and documenting records counts. The coordinator researches and corrects weekly rejected or unprocessed transactions to ensure they are resolved and accepted. The coordinator maintains trends and benchmark report for all submissions. The coordinator also assists with testing and documentation of software updates. This position reports to the Ezcap Application Manager.

Essential Functions

• Generates and submits weekly 837 (ANSI-X12) EDI files to health plan partners
• Verifies acceptance of data with health plan partners
• Escalates issues to Application Manager related to failed transmissions or rejections of EDI transactions
• Performs reconciliation of records to ensure acceptance by trading partners
• Maintains monthly summaries of completed and rejected transactions
• Develops and maintains reports
• Corrects weekly rejected transactions using clearing house or health plan portal
• Updates weekly reports to include errors, corrections and unresolvable errors
• Assist with EDI testing and software upgrades
• Assists with new client implementation as needed
• Assist with projects as needed
• Performs other related duties as assigned.

Experience

• 2-3 years’ experience in managed care setting (referral process, claims process)
• 2-3 years’ experience with ICD-10 and CPT coding
• Working knowledge of EZ-Cap and Crystal Reporting applications.
• Proficient in Microsoft Excel

Requirements

• Covid-19 Booster

Performance Requirements

Knowledge:

• Knowledge of managed care operations (prior authorization, claims, and eligibility functions)
• Knowledge of the EZ-Cap and Crystal operating system.

Skills:

• Possess tact and diplomacy in interpersonal interactions.

Abilities:

• Ability to project a pleasant and professional image.
• Ability to plan, prioritize and complete delegated tasks.
• Ability to demonstrate compassion and caring in dealing with others.

Equipment Operated: Computers, copier/scanners, fax machines, phones.

Work Environment: Well-lit, well-ventilated, adequate office space.

Mental/Physical Requirements: Ability to lift 30lbs, work at a computer with intermittent breaks.

Job Type: Full-time

Pay: From $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• Have you received the Covid-19 Booster?
• What is your desired wage range?

Education:

• High school or equivalent (Preferred)

Experience:

• Data entry: 1 year (Preferred)
• Managed care: 1 year (Preferred)
• ICD-10: 1 year (Preferred)
• CPT coding: 1 year (Preferred)
• Microsoft Excel: 1 year (Preferred)
• Analysis skills: 1 year (Preferred)
• EZ-Cap software: 1 year (Preferred)

Work Location: One location

jjbodyshop.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, jjbodyshop.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, jjbodyshop.com is the ideal place to find your next job.