Lead Electronic Data Interchange (EDI) Specialist

Youre more valuable than ever And thats just how well make you feel.

Summary
The Lead Electronic Data Interchange Specialist is responsible for overseeing daily system accessrequests and technology support tickets ensuring timely resolution and adherence to service levelagreements (SLAs). The role is responsible for monitoring ticket queues in the Electronic MedicalRecords system (EMR) maintaining accurate system documentation and collaborating withinternal teams and external vendors to troubleshoot issues. The position also supports revenuecycle operations by assisting with work queue assignments identifying billing edit root causes andimplementing solutions to reduce claim denials. Additionally the role includes assisting withreporting facilitating team training and serving as a liaison between departments and externalpartners to enhance system efficiency and billing accuracy.

Qualifications
Education Required:
Associates degree in Business Healthcare Administration or related field
Equivalent experience will be considered in lieu of degree.

Licenses/Certifications Required:
None

Work Experience Required:
2 years of experience in healthcare revenue cycle
2 years of Epic experience

Preferred Qualifications Education Licenses Certifications Experience etc.:
1 year of experience in a lead or supervisory role preferred
Experience with Zotec and/or clearinghouse platforms preferred

Knowledge Skills and Abilities
Strong knowledge in professional billing claims coding and/or insurance follow-up
Strong organizational and time management skills.
Excellent communication and problem-solving abilities.
Proficiency in Microsoft Office (Word Excel PowerPoint).
Ability to analyze and resolve access and system issues.
Familiarity with Zendesk and Service Now ticketing systems and workflow tools.

Detail-oriented with a commitment to accuracy and compliance.
This role involves interaction and collaboration with other departments and requiresexcellent judgment and interpersonal skills.

Essential Duties and Responsibilities
Manage and prioritize daily Epic system access requests and Zendesk tickets to ensuretimely resolution.
Monitor ticket queues and escalate issues as needed to meet SLA requirements.
Maintain accurate records of user access and system configurations.
Collaborate with users IT and vendor partners to troubleshoot and resolve system issues.
Assist with developing reports on ticket trends resolution ticket age and turnaround timesfor leadership review.
Review and analyze billing edits and clearinghouse rejections to identify root causesdocument findings and collaborate with manager for solution.
Assist leader in providing work queue assignments training and support to team memberson billing processes and error resolution.
Provide direct oversight and support to both in-office and remote team members serving asa primary resource for addressing questions concerns and clarification related to billingprocesses workflows and operational procedures.
Conduct weekly check-ins with team members (EDI Specialists) to assess workloaddistribution address challenges and reinforce performance expectations.
Compile and present weekly summaries of team member performance system issues andresolution status to leadership and provide feedback and recommendations for strategicimprovements.
This role involves interaction and collaboration with other departments and requiresexcellent judgment and interpersonal skills.

GoHealth Core Values
GoHealths Core Values listed below are essential functions of this position:

Collaboration: Takes ownership for collectively establishing productive partnerships andrelationships and seek to gain joint understanding of priorities and objectives so that thegreater good of the organization and those we serve is always at the forefront.

Innovation: Consistently uses good judgment applying creativity to overcome obstaclesand increasing effectiveness and efficiency through process and other forms of innovation.
Diversity & Inclusion: Fosters diversity and inclusion to be able to better understandteam members our customers and partners. Engages the strengths and talents of eachGoHealth team member creating an environment of involvement respect and connectionwhere the richness of ideas backgrounds and perspectives are harnessed.
Courage & Integrity: Models and practices the highest ethical and professional standards;demonstrates pride and personal interest in our patients partners and fellow teammembers deeply engaging in the business. Makes decisions with a focus on doing the rightthing; treats team members our customers partners and vendors with dignityconsideration open-mindedness and respect.
Accountability: Always shows initiative demonstrates a bias to action and gets thingsdone. Actively accepts responsibility for diverse roles obligations and actions thatpositively influence patient and customer outcomes our partnerships and the healthcareneeds of our communities.

GoHealth Leadership Principles
GoHealths Leadership Principles listed below are essential functions for this position:
Create Shared Purpose: Breathe life into our vision and mission. Speak to our future andcreate a line of sight for our team members. Set goals and communicate a plan of others to deliver.
Inspire and Motivate: Celebrate and share success. Grow and develop our team direct feedback that enables others to reach their potential. Identify when to leadand embrace the opportunity to follow.
Plan Execute Adapt and Deliver: Leverage analytics and experience to make betterdecisions. Possess a bias towards action and manage risk. Be agile pragmatic and acknowledge plan implement and follow-up.

Physical Requirements
Office Environment: Tasks may be conducted within a climate-controlled office setting.
Physical Activity: The role may require the ability to lift carry push or pull materialssupplies and equipment (up to 25 lbs.) Duties typically involve a combination of sittingstanding and walking with frequent changes in position.
Travel: Travel may be required including travel between facility locations remotefacilities and out-of-town destinations as needed.
Safety Equipment: May require the use of safety equipment for infection prevention.

Note: This Job Description is not inclusive of all the duties of the position. You may be asked by Leadersto perform other duties. Leadership may revise this job description at any time.

Equal Employment Opportunity Statement
The Company and its affiliates joint venture partners and entities under common management areEqual Opportunity Employers. They do not discriminate based on race color religion nationalorigin age sex disability veteran status sexual orientation gender identity or any other protectedstatus under federal state or local law.

ADA Accommodation Statement
Reasonable accommodations are available for qualified individuals with disabilities upon role defines success by achieving essential function outcomes not by the method ofcompletion.

Compliance Statement
This job will be performed consistent with ADA FMLA FLSA and other applicable federal stateand local laws regulating employment.

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All qualified persons are granted an equal opportunity for employment without regard to race color religion sex sexual orientation and gender identity or expression age national origin citizenship status disability genetic information medical condition family care leave status pregnancy or pregnancy-related condition otherwise qualified disabled or veteran status. The company will comply with all fair employment laws in each of the jurisdictions where we conduct business.

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