Sr. Support Specialist EDI Position Available In Charleston, South Carolina

Sr. Support Specialist EDI
Full Time
Charleston, SC, Charleston, SC, US
+1 More Locations
14 days ago

Requisition ID:

2283

Salary Range:

$17.00 To $22.00 Hourly 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? We are looking for a highly skilled and experienced Senior Support Specialist, EDI to join our dynamic and growing team. This pivotal role is ideal for a professional with in-depth knowledge of electronic data interchange (EDI), healthcare claim submission standards, and pharmacy operations. You will lead the coordination and execution of EDI processes, manage complex claims submissions, interpret payer reports, and act as a subject matter expert to ensure operational excellence across our claims and billing ecosystem. This position requires exceptional analytical capabilities, deep understanding of EDI file formats (837/835), strong communication skills, and a history of successful cross-department collaboration. You may be hired as a Support Specialist, or Sr. Support Specialist based on your depth of skill and breadth of experience. What will you do? Manage and oversee the full lifecycle of 837 EDI claims submissions, ensuring accuracy, compliance, and timely delivery to healthcare payers.
Interpret and analyze acknowledgment reports, proactively resolving errors or rejections related to batch and individual claims.
Deliver and maintain custom 835 remittance files via secure SFTP, ensuring alignment with customer/vendor requirements.
Maintain a detailed and auditable daily log of claim submissions, confirming complete claim processing and payment reconciliation.
Serve as the lead liaison for payer communications, tracking claim status, addressing escalated issues, and maintaining positive working relationships with stakeholders.
Strategically update pharmacy claims in internal systems and ensure all SOPs remain current, accurate, and compliant with regulatory standards.
Lead and resolve complex Jira tickets and Salesforce cases, serving as a senior escalation point for claim and EDI-related issues.
Mentor and train junior staff, sharing best practices and fostering a culture of continuous learning and improvement.
Partner with IT and cross-functional teams to identify process improvement opportunities, develop system enhancements, and implement automation strategies.
Document and maintain up-to-date EDI process guidelines, knowledge bases, and workflows for internal and external audits. This is an onsite position at one of our offices Dallas, Texas or Daniel Island, Charleston, South Carolina. What education and experience do you need? A combination of the following education and experience factors will be considered:

Education & Experience:

High school diploma or equivalent required. Bachelor’s degree in Healthcare Administration, Information Technology, Business, or a related field strongly preferred.
5+ years of experience in EDI operations or healthcare claims, preferably within a pharmacy or PBM environment.
Expert-level knowledge of HIPAA-compliant EDI transactions (837P/I, 835) and payer-specific requirements.
Proven experience with Medicare and Medicaid claims processing and regulatory frameworks.
Strong analytical and troubleshooting skills, with the ability to evaluate complex issues and implement strategic solutions.
Proficiency in Microsoft Office (particularly Excel for data analysis) and familiarity with EDI tools, Salesforce, Jira, and secure file transfer protocols (SFTP).
Excellent verbal and written communication skills with the ability to work effectively across teams and with external partners.
High level of detail orientation, organization, and the ability to manage multiple priorities in a fast-paced, high-volume environment.
Demonstrated leadership in mentoring and supporting junior team members and contributing to team-wide knowledge growth. 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 range for this role is $17.00-$22.00 hourly compensation. Please note this range is an estimate and actual may vary based on qualifications and experience. 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 EEO Statement XiFin is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.