Healthcare EDI & Claims Coordinator

BAKERSFIELD FAMILY MEDICAL GROUP, INC.; Bakersfield (CA); On-site; USD 39,000 - 46,000; Full time

Job summary

Bakersfield Family Medical Group, Inc. in Bakersfield, CA is seeking a detail-oriented Claims & Encounter EDI Coordinator to ensure accurate processing and transmission of electronic claim and encounter files.

You will load daily claim data into EZ-CAP, monitor processing, maintain logs, and securely transmit encounters to clearinghouses while following HIPAA procedures. The role emphasizes reliability, routine tasks, and timely completion.

Qualifications

• High School Diploma or equivalent.
• Experience in a detail-oriented administrative, healthcare, claims, billing, data-processing, or transactional environment.
• Dependable and able to consistently complete time-sensitive daily and weekly responsibilities according to established schedules.
• Ability to maintain accuracy and attention to detail while performing repetitive or routine tasks.
• Demonstrated ability to follow detailed written procedures
• Strong organizational skills
• Ability to manage recurring deadlines

Responsibilities

• Receive and in-load daily electronic claim transaction files into EZ-CAP according to established procedures and schedules.
• Run required daily processes to prepare claims for adjudication.
• Verify that expected files have been received and processed successfully and identify missing, duplicate, rejected, or incomplete files.
• Maintain daily processing logs, reconciliation records, and other required tracking documentation.
• Create, validate, and securely transmit encounter files to the designated clearinghouse or trading partner according to established weekly schedules.
• Review clearinghouse acknowledgements and rejection reports and complete documented correction or follow-up procedures.
• Reconcile claim and encounter file receipt and submission activity to help ensure complete and timely transfer of data.
• Follow established HIPAA-compliant procedures for the secure transmission and handling of electronic healthcare information.
• Complete daily, weekly, and monthly processing tasks accurately and within required deadlines.
• Follow written procedures, processing checklists, and established workflows consistently and maintain documentation when processes change.
• Identify unusual results, processing failures, discrepancies, or issues and promptly promote them to the appropriate team member or supervisor.
• Communicate pending items, processing issues, and potential missed deadlines to the supervisor in a timely manner.
• Assist with testing of new or modified claim and encounter processes as directed.
• Other duties as assigned.

Skills

Detail-oriented

Administrative experience

Healthcare experience

Data processing

Timely deadlines

Education

High School Diploma or equivalent

Tools

EZ-CAP

Clearinghouse

Healthcare data exchange systems

Job description

Bakersfield Family Medical Group, Inc. in Bakersfield, CA is seeking a detail-oriented Claims & Encounter EDI Coordinator to ensure accurate processing and transmission of electronic claim and encounter files.

You will load daily claim data into EZ-CAP, monitor processing, maintain logs, and securely transmit encounters to clearinghouses while following HIPAA procedures. The role emphasizes reliability, routine tasks, and timely completion.