Job Description

We are seeking a skilled

EDI Specialist

to manage and support all

Electronic Data Interchange (EDI)

functions across multiple healthcare clients. The ideal candidate will have hands-on experience working with EDI transactions, payer enrollments, and clearinghouse configurations within medical billing systems. This role requires someone knowledgeable, proactive, and able to work independently with minimal supervision.

Key Responsibilities:

Monitor and resolve

EDI claim rejections

received from clearinghouses and insurance payers. Troubleshoot and correct

EDI errors

(invalid payer IDs, missing loops/segments, NPI/Tax ID mismatches, etc.) and ensure successful rebilling. Manage

EDI claim (837) setup and maintenance

for new providers and practices. Handle

ERA (835) enrollments

to enable automated remittance posting. Complete and track

EFT enrollments

for direct deposit with payers. Coordinate

payer EDI connectivity

setup including trading partner agreements and clearinghouse registrations. Maintain

EDI logs and status trackers

for enrollments and production issues. Collaborate with billing/RCM teams to ensure accurate claim configuration and payer mapping. Work directly in clearinghouse portals (such as Availity, Office Ally, Change Healthcare, TriZetto, etc.) Communicate professionally with payers/carries to follow up on enrollments or resolve EDI escalations. Perform periodic

EDI audits

to identify recurring issues and recommend improvements.

Preffered Skills & Experience:

2+ years of experience

working in medical billing or RCM with EDI transactions Strong knowledge of

ANSI X12 transactions

(837, 835, 999, 277CA) Hands-on experience with

EDI claim rejections and correction workflows

Experience submitting

ERA/EFT enrollments

with major payers (Medicare, Medicaid, BCBS, UHC, Aetna, Cigna, etc.) Proficiency in

clearinghouse portals

such as Availity, Change Healthcare, Office Ally, TriZetto, etc. Familiarity with billing platforms such as

eClinicalWorks (eCW), Tebra, Kareo, Drchrono, Inovalon, AdvancedMD, or similar

Strong Excel skills for tracking and reporting Excellent investigation, documentation, and communication skills Ability to

work independently and meet deadlines

Strong understanding of

HIPAA, NPI, taxonomy codes, and payer setup

Work Arrangement & Compensation:

Contract role

Flexible working hours with

availability between 9 AM - 6 PM EST

for communication Long-term collaboration opportunity Compensation based on experience; paid

per project, per enrollment, or hourly

Job Type: Full-time

Pay: ₹25,000.00 - ₹45,000.00 per month

Benefits:

Paid time off
Application Question(s):

Describe your process for troubleshooting recurring EDI rejections across multiple claims. What are the differences between ERA enrollment and EFT enrollment? Which clearinghouses have you worked with? What causes this rejection and how do you resolve it: "Claim rejected: Billing Provider Tax ID and NPI mismatch Which billing systems/EMRs do you have hands-on experience with? How many years of experience do you have working specifically with EDI in medical billing/RCM? How much is your expecations for salary?
Work Location: Remote