EDI Specialist

POSITION SUMMARY

The EDI Specialist role is responsible for the retrieval and submission of inbound and outbound data.  Including daily auditing and reconciliation of data on a department level, to include internal staff and external vendors.  The Specialist is also responsible for training staff on all new or updated procedures. 

ESSENTIAL FUNCTIONS

• 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

EDUCATION 

• High School Diploma or equivalent required.

EXPERIENCE AND SKILLS

• 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.

POSITION COMPETENCIES

• Communication
• Customer Focus
• Accountability
• Functional/Technical Job Skills

PHYSICAL DEMANDS

• This is a standard desk role – long periods of sitting and working on a computer are required.

WORK ENVIRONMENT

• Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.