Electronic Data Interchange (EDI) Specialist Position Available In Alachua, Florida

Electronic Data Interchange (EDI) Specialist The Cardiac and Vascular Institute – 3.0

Gainesville, FL Job Details Full-time Estimated:

$35.8K – $42.8K a year 2 days ago Qualifications

EDI HIPAA

Mid-level Microsoft Office 3 years High school diploma or GED Cardiology Communication skills Full Job Description Electronic Data Interchange (EDI)

Specialist Hours of Work:

M-F Employment Type:

Full Time Shift:

Day Overview Under general supervision, this position supports the vision and mission of The Cardiac and Vascular Institute. Expectations include, but are not limited to, managing the setup, transmission, and troubleshooting of electronic healthcare transactions, ensuring clean and timely submission of electronic claims, remittances, eligibility inquiries, and other EDI functions. The EDI Specialist serves as a liaison between internal teams, clearinghouses, and payers to ensure smooth electronic data exchange. This role assists the department by optimizing EDI workflows, meeting performance goals, and maintaining compliance with payer requirements and HIPAA regulations. Key Responsibilities Monitor, troubleshoot, and resolve EDI file submission issues to ensure timely claims and remittance processing Coordinate with clearinghouses, payers, and internal stakeholders to resolve transmission errors and rejection reports. Analyze electronic claim rejections and edits, implement corrective actions, and resubmit claims as needed. Support onboarding and implementation of new payers or EDI transaction types, including enrollment and testing. Ensure compliance with payer-specific EDI requirements, HIPAA regulations, and organizational policies. Identify opportunities to improve EDI processes to enhance claim acceptance rates and reduce denials. Work closely with the Revenue Cycle and IT departments to ensure systems integration and data integrity. Assist in training team members on EDI workflows and provide ongoing support as system or payer updates occur. Meet or exceed the department’s established performance targets (productivity and quality). Track and report on EDI metrics and escalate unresolved issues appropriately. Knowledge, Skills and Abilities Strong understanding of healthcare EDI transactions (837, 835, 270/271, 276/277) and payer requirements. Knowledge of clearinghouse operations and payer enrollment processes. Strong attention to detail, analytical thinking, and problem-solving skills. Ability to work independently and collaboratively with cross-functional teams. Proficiency with computer systems and software, including Microsoft Office Suite, EHR/Practice Management Systems, and clearinghouse portals. Knowledge of HIPAA regulations and EDI compliance standards. Excellent verbal and written communication skills to interact with internal staff, vendors, and payers. Ability to manage multiple priorities and adapt to changing needs in a fast-paced environment. Excellent verbal and written communication skills to interact with internal staff, vendors, and payers. Qualifications High School Diploma or equivalent (GED). 3 years’ experience working with healthcare EDI transactions or in a medical billing/claims environment. Preferred Qualifications Cardiology Experience Experience working with Intergy Practice Management System. Experience working with WayStar Clearinghouse. Certification in EDI or healthcare data management. Additional Information All your information will be kept confidential according to EEO guidelines.