Electronic Data Interchange (EDI) Enrollment Specialist

Posted 2025-10-26
Remote, USA Full Time Immediate Start
Job Title: EDI Enrollment Specialist Department: Revenue Cycle Reports To: Director of Revenue Cycle Job Type: Full-Time Location: Preferred onsite- Gilbert, AZ, Remote Salary: $24 - $27 per hour Job Summary: We are seeking a detail-oriented and highly organized EDI Enrollment Specialist to manage and coordinate the electronic data interchange (EDI) enrollment process with payers, providers, and clearinghouses. The ideal candidate will be responsible for ensuring smooth onboarding of trading partners, maintaining compliance with industry standards, and supporting the setup of EDI transactions such as eligibility (270/271), claims (837), remittance advice (835), and others. Key Responsibilities: • Manage EDI enrollment processes for multiple transaction types (e.g., 837, 835, 270/271, 276/277, 278). • Facilitate EDI enrollment and setup with payers, clearinghouses, and internal departments. • Prepare and submit EDI enrollment forms and documentation to insurance payers and vendors. • Track enrollment statuses and follow up to ensure timely completion. • Collaborate with revenue cycle teams to ensure accurate setup and testing. • Maintain accurate and up-to-date enrollment records and logs. • Assist in troubleshooting EDI-related issues and coordinate resolutions with vendors or payers. • Monitor and ensure compliance with HIPAA and other regulatory standards. • Provide training or support to internal staff regarding EDI processes and best practices, as needed. • Continuously improve processes for efficiency, accuracy, and compliance. Qualifications: Education & Experience: • 2+ years of experience in EDI enrollment or healthcare payer/provider data management. • Familiarity with healthcare EDI transaction standards (e.g., ANSI X12). • Strong knowledge of EDI processes and healthcare claims workflows. • Excellent attention to detail and organizational skills. • Proficient in Microsoft Office (Excel, Word, Outlook). • Experience with clearinghouse portals (e.g., Availity, Change Healthcare, Office Ally). • Strong verbal and written communication skills. • Ability to manage multiple tasks and meet deadlines in a fast-paced environment. Preferred Qualifications: • Experience working with practice management or revenue cycle management systems. • Knowledge of Medicare, Medicaid, and commercial payer enrollment requirements. • Experience with EDI testing and troubleshooting tools. Apply tot his job Apply To this Job
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