Remote Healthcare EDI Claims Migration Specialist

ZipStaff Inc.; Chapel Hill (NC); A distancia; USD 83.000 - 138.000; A tiempo parcial

Ventajas ofrecidas por este puesto de trabajo

Health Insurance

Dental Insurance

Vision Insurance

401(k) + 401(k) matching

Paid time off

Referral Program

Descripción de la vacante

ZipStaff Inc. is seeking an EDI Claims Implementation Specialist to support a Massachusetts Medicaid client through a system migration.

This remote, US-based contract role focuses on inbound claim ingestion, mapping, and pre-adjudication work, bridging claims processing across platforms. You will handle post-adjudication 837 encounter reporting, validation, and reconciliation, and collaborate with cross-functional teams to ensure a smooth cutover while maintaining compliance with Medicaid

Formación

• 5+ years hands-on EDI claims implementation in healthcare insurance.
• Strong inbound 837 claim ingestion, mapping, validation and routing.
• Post-adjudication 837 encounter reporting experience.
• Recent 4 years in healthcare claims, eligibility and accumulators.
• Authorized to work in the United States without sponsorship.

Responsabilidades

• Migrate Massachusetts Medicaid client from one claims system to another.
• Own inbound/pre-adjudication 837 intake, mapping and routing.
• Handle post-adjudication 837 encounter reporting: extraction, submission, and reconciliation.
• Assess impacts to adjudication, eligibility, and accumulators during transition.
• Validate data across platforms and drive defect resolution through cutover.
• Collaborate with functional and technical teams to keep migration on track.

Conocimientos

EDI claims

Inbound claims

Post-adjudication reporting

System migrations

Healthcare insurance

Descripción del empleo

ZipStaff Inc. is seeking an EDI Claims Implementation Specialist to support a Massachusetts Medicaid client through a system migration.

This remote, US-based contract role focuses on inbound claim ingestion, mapping, and pre-adjudication work, bridging claims processing across platforms. You will handle post-adjudication 837 encounter reporting, validation, and reconciliation, and collaborate with cross-functional teams to ensure a smooth cutover while maintaining compliance with Medicaid