Job Summary:
We are seeking a detail-oriented and technically skilled professional to serve a dual role in managing Electronic Data Interchange (EDI) systems and overseeing Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) processes. This position is responsible for supporting, developing, and maintaining EDI workflows to ensure seamless communication to Practice’s, while also managing the accurate documentation, reconciliation, and posting of electronic payments from payers. The ideal candidate will work closely with internal teams and external partners to troubleshoot issues, optimize electronic transaction processes, and ensure the integrity of healthcare billing and payment systems.
Key Responsibilities:
Maintain trading partner relationships and provide support during onboarding or system changes.
Troubleshoot EDI issues related to data mapping, transmission errors, and integration problems.
Monitor daily EDI transactions to ensure successful processing and timely resolution of errors or issues.
Manage daily EDI operations including ticket resolution, change requests, and partner issues.
Collaborate with project managers and business analysts to support business
Communicate with practices and RCM regarding any challenges or issues and provide timeline(s) to resolve.
Maintain documentation on ERA/EFT processes and payer communications.
Coordinate with insurance companies, clearinghouses, and internal departments to address payment issues.
Set up and maintain ERA/EFT enrollment with new payers and ensure compliance with payer requirements
Qualifications:
Required:
2+ years of experience in EDI analysis, mapping, and support.
Strong knowledge of ERA/EFT processes and healthcare reimbursement practices.
Familiarity with clearinghouses, payer portals, and electronic billing software.
Strong analytical, problem-solving, and communication skills.
Experience with enrollment processes for ERA/EFT with major commercial and government payers.
UnderstandingHIPAA and healthcare payment compliance requirements.
Preferred:
Proficient in Microsoft Excel and billing systems (e.g., Acuity Logic (Eyefinity), Compulink, RevCycle)
Knowledge of CPT, ICD-10, and HCPCS coding (for identifying posting errors)
Knowledge of TriZetto, InstaMed, Availity, Change Healthcare, etc.
Key Competencies:
Technical proficiency with data formats and EDI systems
Strong organizational skills and attention to detail
Ability to manage multiple projects and priorities
Team collaboration and vendor communication
Analytical mindset and process improvement orientation
United States
