EDI Implementation Specialist AIS
EDI Implementation Specialist AIS
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Job Description
Create the future of e-health together with us by becoming an EDI Implementation Specialist
At CompuGroup Medical we have the mission of building ground-breaking solutions for digital healthcare. Our vision is revolutionizing how healthcare professionals produce access and utilize information and thus enabling them to focus on the core value of their work: patient outcomes.
Your Contribution:
Initiates and facilitates the payer enrollment process by requesting receiving validating and submitting enrollment applications for new providers and any provider changes.
Provides updates to payers regarding provider and entity records such as banking information EFT correspondence address ownership and more.
Maintains and oversees payer portal access for providers and entities. Also monitors application statuses and follows up with payers to ensure timely approvals.
Works collaboratively with clients department managers and external agencies to facilitate and ensure a seamless hand-off during the payer enrollment process.
Utilizes critical thinking skills to conduct follow-ups with individual practitioners and both internal and external entities to resolve discrepancies identified during the payer enrollment process.
Manages enrollment processes for new providers and facilities with Medicare Medicaid and private insurance plans.
Acts as a liaison between providers and payers to address and resolve credentialing and enrollment issues.
Prepares reviews and submits credentialing applications for healthcare providers with commercial and government payers.
Your Qualification:
A bachelors degree in business healthcare or a related field along with 3-5 years of progressive experience in payer enrollment is strongly preferred.
Alternatively minimum of 10 years of experience in credentialing/enrollment and/or revenue cycle management may be accepted in lieu of a degree.
Minimum of three years of experience in healthcare credentialing and provider enrollment is required.
Familiarity with the enrollment processes for Medicare Medicaid and commercial payers is essential. Knowledgeable in all aspects of payer enrollment including knowledge of regulatory & compliance standards as well as Medicare Medicaid and commercial payer enrollment processes.
Experience training or teaching clients to use software or technical product.
What you can expect from us:
Purpose: Become part of an important mission. At the interface between healthcare and digitization we create the future of e-health.
Equal Opportunity Employer: At CGM we value our team members and strive to create an environment where everyone has the opportunity to succeed.
Career Opportunities: We are offering a variety of internal career opportunities and numerous long-term perspectives.
Security: We offer a secure workplace in a crisis-proof market.
All-round benefits package: Medical Dental and Vision as well as 401k with employer matching. Personal Time Off to promote work life balance.
Work environment: Modern workplaces flexible working hours hybrid work options and much more.
Convinced Submit your application now! Please make sure to include your salary expectations as well as your earliest possible hire date.
We create the future of e-health.
Become part of a significant mission.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
