EDI Specialist: Claims & Revenue Cycle Champion

MedVanta Interco, LLC.; Bethesda (MD); On-site; USD 30,000 - 34,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) retirement plan with employer"s

Paid time off and paid holidays

Employer-paid life insurance

EAP

Job summary

MedVanta is seeking an EDI Specialist to manage daily claim submission workflows, ensuring electronic and paper submissions are accurate and timely. The role coordinates with billing, registration, coding, and authorization teams to resolve front-end revenue cycle issues.

Qualifications include a high school diploma with a preference for a Bachelor’s in Healthcare Administration or Business Administration, EDI certification, and familiarity with ANSI X12 standards and multiple EDI platforms.

Qualifications

• Strong understanding of claim basics: subscriber vs patient, provider types, NPI/taxonomy, POS, ICD-10/CPT/HCPCS.
• Familiarity with clearinghouse portals and payer websites.
• Experience with high-volume multi-site physician group billing.

Responsibilities

• Manage daily claim submission workflows for electronic and paper claims, ensuring timely release.
• Submit and monitor primary, secondary, and tertiary claims with correct payer sequencing.
• Confirm required supporting data before submission (EOB/ERA, COB details, payer IDs).
• Prepare and submit paper claims when required with proper attachments and dates.
• Track submission confirmations and acceptance status; follow up on rejected/not-submitted claims.

Skills

Communication

Time management

Cross-functional collaboration

Education

Bachelor’s degree in Healthcare Administration or Business Administration

EDI certification

Tools

EDI software platforms

ANSI X12 (837P/835/276-277)

Job description

MedVanta is seeking an EDI Specialist to manage daily claim submission workflows, ensuring electronic and paper submissions are accurate and timely. The role coordinates with billing, registration, coding, and authorization teams to resolve front-end revenue cycle issues.

Qualifications include a high school diploma with a preference for a Bachelor’s in Healthcare Administration or Business Administration, EDI certification, and familiarity with ANSI X12 standards and multiple EDI platforms.