Receive and submit files to and from various vendors daily.
Process 837 files resulting in conversions of .txt files.
Prep and transfer files to be loaded into internal programming system for processing and payment.
Encrypt and decrypt files.
Run queries in Access.
Run and review reporting in Excel.
Conduct eligibility matching based on enrollee and members demographics within the internal master database.
Accurately routing completed claims to various internal mailboxes, attention to detail and emphasis on accuracy and meeting timelines successfully.
Train EDI Coordinators on various workflow to include new or updated procedures.
Interprets and explain procedures to EDI Coordinators.
Handle internal audits for the department to include internal staff and external vendors.
Handle ongoing projects within the department when necessary, while maintaining the current workflows assigned.
Handle complex issues within the department, when additional assistance is needed from other departments, staff, or outside vendors.
Provide EDI support for outside trading partners and internal staff.
Processing of failed transactions and resolve missing acknowledgments.
Performs other related duties as assigned

High School Diploma or equivalent required.
Data Entry 6,000 keystrokes per hour with accuracy.
Intermediate knowledge of Word, Excel, and Access.
Good problem-solving skills.
Analytical skills.
Highly motivated and the ability to work well independently and within a team environment.
Attention to detail and accuracy.

EDI Specialist

About this role