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Job Description
- Req#: 8534
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Lead and mentor a team of EDI/ERA analysts responsible for managing electronic transactions (837, 835, 270/271, etc.).
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Oversee configuration, monitoring, and maintenance of EDI transactions and ERA posting systems within the healthcare revenue cycle.
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Ensure successful transmission and reconciliation of electronic claims and remittance advice files.
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Serve as a subject matter expert for HIPAA-compliant EDI standards (X12 formats) and healthcare billing workflows.
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Troubleshoot EDI/ERA issues, analyze file errors or rejections, and coordinate resolution with clearinghouses, payers, and internal teams.
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Collaborate with IT and billing teams to implement new payer connections, manage EDI enrollment, and maintain trading partner relationships.
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Monitor daily EDI/ERA transaction logs and system queues to ensure timely processing.
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Document workflows, procedures, and business rules related to EDI/ERA operations .
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Participate in system upgrades, testing, and optimization projects for EDI platforms and practice management systems.
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Oversee configuration, monitoring, and maintenance of patient statements , EDI transactions , and ERA posting systems within the healthcare revenue cycle.
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Document workflows, procedures, and business rules related to Patient Statements.
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Collaborate with IT, RCM and Practices to implement new payer connections, manage EDI enrollment, and maintain third party vendor relationships .
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Generate operational reports and performance metrics; provide insight to leadership and stakeholders.
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5+ years of healthcare administration experience, including EDI/ERA experience wit h solid knowledge of HIPAA transaction sets (especially 837/835).
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2+ years of experience in leadership or supervisory capacity .
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Familiarity with clearinghouses (e.g., Trizetto , C hange Healthcare, Availity, Office Ally) and payer portals.
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Experience with revenue cycle systems (e.g., Epic, Cerner, NextGen, Athena, eClinicalWorks, etc.).
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Strong problem-solving, analytical, and communication skills .
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Ability to train and develop team members.
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Proficient in Microsoft Excel and billing systems (e.g., Acuity Logic (Eyefinity), Compulink, RevCycle )
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Knowledge of CPT, ICD-10, and HCPCS coding (for identifying posting errors)
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Knowledge of TriZetto, I nstaMed , Availity, Change Healthcare, etc .
Job Title: E lectronic Healthcare Data Manager
Location: Remote
Job Type: Full-Time
Department: Revenue Cycle Management
Reports to: Director of Contract ConfigurationJob Summary:
We are seeking an experienced E lec t ronic Healthcare Data Manager to oversee the day-to-day operations of a team of analysts supporting EDI , ERA , and related clearinghouse processes including enrollments, patient statements and healthcare data exchange. This role comb ines tech nical expertise in electronic transaction processing with leadership responsibilities to ensu re th e accu rate and timely flow of claims, remittances, and other healthcare transactions between payers, providers, and internal systems.
Key Responsibilities:
Qualifications:
Required:
Preferred:
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About the company
Through acquisition and partnership, we can help take your practice and your staff to the next level.
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