Support Specialist EDI

XiFin Pharmacy Solutions; San Diego (CA); Presencial; USD 25.000 - 33.000; Jornada completa

Descripción de la vacante

XiFin is seeking a Support Specialist EDI in San Diego to coordinate with healthcare payers, manage claims submissions, and interpret payer reports to optimize EDI operations.

The ideal candidate will have a solid understanding of EDI processes, plus strong communication and teamwork skills to collaborate across departments.

Formación

• Bachelor’s degree in healthcare admin, IT or related field required.
• Minimum 3 years of EDI support or healthcare role.
• Deep knowledge of Medicare/Medicaid policies and EDI standards.
• Strong analytical, communication, and cross-team collaboration skills.
• Proficiency with MS Office and EDI-related software.

Responsabilidades

• Oversee submission of EDI files to payers and interpret payer reports.
• Maintain proprietary systems ensuring accuracy and compliance.
• Analyze and resolve claim issues, including batch or claim rejects.
• Monitor payer communications and respond promptly to inquiries.
• Document EDI processes and updates comprehensively.
• Collaborate with IT and other departments to improve processes.
• Train and mentor entry-level staff and new hires.

Conocimientos

Strong communication skills

Analytical skills

Multi-tasking

Collaboration across teams

Problem-solving

Educación

Bachelor’s degree in healthcare administration, information technology, or related field

Herramientas

MS Office (Word, Excel)

EDI software

Descripción del empleo

At XiFin, a culture of inclusivity is in our very fabric. We believe that this culture not only creates a more equitable and functional workplace, but also enhances our team members' work experiences by promoting creativity, innovation, and collaboration.

Who are we looking for?

As a Support Specialist EDI, you will be responsible for coordinating with healthcare payers to manage claims submissions, interpret payer reports, and enhance the efficiency of our EDI operations. The ideal candidate will have a strong understanding of EDI processes, excellent communication skills, and the ability to work collaboratively across departments.

What will you do?

• Oversee the submission of EDI files to healthcare payers and manage the receipt and interpretation of payer reports.
• Update and maintain proprietary systems, ensuring accuracy and compliance with industry standards.
• Analyze and resolve claim issues, including batch and claim rejects, providing guidance to junior team members.
• Monitor payer communications and ensure timely responses to inquiries and issues.
• Maintain comprehensive documentation of EDI processes and updates.
• Collaborate with IT and other departments to implement process improvements and enhance system functionality.
• Assist with training and mentoring entry-level staff and new hires.

What education and experience do you need?

• Bachelor’s degree in healthcare administration, information technology, or a related field preferred.
• Minimum of 3 years of experience in EDI support or a similar role within the healthcare industry.
• In-depth knowledge of Medicare/Medicaid policies and EDI standards.
• Strong analytical skills with the ability to troubleshoot complex issues effectively.
• Excellent communication and interpersonal skills to facilitate collaboration across teams.
• Proficiency in MS Office applications (Word, Excel) and EDI-related software.
• Proven ability to manage multiple priorities and work in a fast-paced environment.

What’s in it for me?

We don't just offer benefits; we offer a comprehensive and flexible benefits package tailored for you!

• Dive into a world of cutting-edge healthcare with our comprehensive medical, dental and vision benefits, including telehealth services. Say goodbye to the hassle of prescriptions with our convenient mail-order program for 90-day maintenance medications.
• Our Health Savings Account (HSA) featuring pre-tax deductions and quarterly company contributions (HSA only) puts more money in your pockets!
• Plan for your golden years with confidence through our 401k retirement plan, complete with a company match.
• Fuel your ambition with our Tuition Assistance program, empowering you to reach new heights in your professional journey.
• Finally, experience true well-being with XiFin's BeWell Program, where we champion physical, mental, financial, and social wellness, because your success and happiness are our ultimate priorities

Why XiFin?

XiFin is a healthcare information technology company that empowers healthcare organizations to navigate an increasingly complex and evolving healthcare landscape. Through innovative AI-enabled technologies and services, we deliver operational efficiency, interoperability, and simplicity. The company’s revenue cycle management, clinical workflow enablement, laboratory information system, and patient engagement solutions enable organizations to achieve stronger finances, streamline operations, and develop industry-leading business strategies.

Helping healthcare providers achieve financial strength empowers them to do more good for more people. That’s THE POWER TO DO GOOD.

What does the position pay:

Compensation is determined by several factors which may include skillset, experience level, and geographic location. The expected hourly range for this role is $18.00-$24.04

If you are an individual with a disability and would like to request a reasonable accommodation as part of the application or recruiting process, please contact us at 858-436-2901.