EDI Specialist: Revenue Cycle Claims Expert

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

Job summary

MedVanta, LLC in Bethesda, MD, is seeking an EDI Specialist to manage daily electronic and paper claim submissions and coordinate with payers and clearinghouses. You will monitor submissions, resolve rejections, and ensure COB and eligibility data are correct across multi‑site billing.

The role requires strong knowledge of EDI (837P/835/276‑277), experience with payer networks, and excellent communication. Bachelor's degree or related certification is preferred for success.

Qualifications

• High school diploma or GED required; bachelor’s preferred.
• EDI certification strongly preferred.
• Experience with EDI and payer workflows encouraged.
• Familiarity with ANSI X12 concepts (837P/835/276-277) and clearinghouse tools.

Responsibilities

• Manage daily claim submission workflows for electronic and paper claims, ensuring timely release based on payer requirements and internal posting/submission schedules.
• Submit and monitor primary (INS1), secondary (INS2), and tertiary (INS3) claims with correct sequencing and COB indicators.
• Verify supporting data for INS2/INS3 submissions (EOB/ERA, patient responsibility, COB details, payer IDs).
• Coordinate EDI-related items such as submitter IDs and payer-specific requirements.
• Track submission confirmations and follow up on non-accepted claims.

Skills

Interpersonal skills

Time management

Multitasking

Communication skills

Education

High school diploma or GED

Bachelor’s degree in Business Administration, Healthcare Administration, or Electronic Data Management

EDI certification

Tools

ModMed/mmPM

Trizetto

Waystar

Change Healthcare

Availity

Microsoft Office

Job description

MedVanta, LLC in Bethesda, MD, is seeking an EDI Specialist to manage daily electronic and paper claim submissions and coordinate with payers and clearinghouses. You will monitor submissions, resolve rejections, and ensure COB and eligibility data are correct across multi‑site billing.

The role requires strong knowledge of EDI (837P/835/276‑277), experience with payer networks, and excellent communication. Bachelor's degree or related certification is preferred for success.