EDI Payer Enrollment Coordinator

Summary

Join Experian Health as the EDI Payer Enrollment Coordinator and manage payer enrollment processes for electronic data exchange between healthcare providers and payer organizations. Facilitate seamless integration of providers into payer networks through EDI enrollment procedures. Collaborate with internal and external teams to ensure compliance. Coordinate and oversee the enrollment process, ensuring timely and accurate submissions. Verify the accuracy of enrollment materials and conduct follow-up. Communicate with clients, payers, and internal staff. Troubleshoot and resolve enrollment issues. Provide training and support to clients on EDI enrollment procedures. Stay updated on payer enrollment changes and share knowledge with the team.

Requirements

• 1+ year of experience with the EDI Payer Enrollment processes
• Familiarity with X12 EDI standards
• An understanding of Healthcare Revenue Cycle Management
• 1+ year of experience managing a high volume of cases simultaneously
• 1+ year of experience strategic thinking and tactical planning with regard to the EDI Payer Enrollment process
• Associates Degree in Healthcare, Business, or related field experience

Responsibilities

• Coordinate and oversee the payer enrollment process, ensuring timely and accurate submissions
• Collaborate with payer organizations to obtain and understand enrollment requirements
• Verify the accuracy and completeness of enrollment materials before submission to payers
• Conduct enrollment follow-up with payers and vendors regarding enrollment application statuses
• Communicate with clients, payers, vendors, and internal staff to provide current enrollment statuses and answer outstanding questions
• Identify, troubleshoot and resolve any enrollment issues
• Provide training and support to clients on EDI enrollment procedures
• Stay updated on payer enrollment changes and share knowledge with the team

Benefits

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays