Prepare and submit EDI claims applications, investigate enrollment denials, and maintain accurate records while supporting healthcare revenue cycle management.
You’ll prepare and submit applications to configure Electronic Data Interchange (EDI) claims and Electronic Remittance Advice (ERA) through clearinghouse and other payer portals
You’ll prepare and submit applications to configure Electronic Funds Transfer (EFT) with payers
You’ll initiate investigation with payers regarding provider enrollment denials and errors
You’ll review correspondence received from payers and action appropriately for resolution
You’ll work as a liaison between the RCM department and Strategy & Operations team to discuss, investigate, and resolve enrollment tasks
You’ll interact with our customers through excellent written and verbal communication
You’ll maintain up-to-date and accurate enrollment records within the Candid Health product
You’ll meet and maintain KPIs/metrics for production and quality
You’ll maintain working knowledge of workflow, systems, and tools used in the department
You’ll maintain HIPAA guidelines
You have at least 2 year of experience in revenue cycle management (for medical billing or within healthcare/healthtech)
You may have experience with submitting and troubleshooting EDI enrollments
You have an investigative mindset and you are comfortable running down problems and suggesting actions based on data
You are a self starter
You take pride in your craft and enjoy maintaining a high quality bar, but also believe that “done is better than perfect” and have good intuition around which corners are okay to cut and which aren’t.
You have excellent oral and written communication skills
You have effective multitasking skills
You have a positive and cooperative attitude in working and communicating with individuals at all levels of the organization
The estimated starting annual salary range for this position is $22-$27 USD per hour. The listed range is a guideline from Pave data, and the actual base salary may be modified based on factors including job-related skills, experience/qualifications, interview performance, market data, etc.
Candid Health is a health tech startup that simplifies the healthcare experience by providing individuals with the tools they need to understand insurance, navigate medical billing, and access essential care. Our solutions improve communication and compliance within a regulated market, making healthcare more accessible and less daunting for consumers.
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