EDI & Claims Operations Analyst

📋 Description

• Monitor claim status activity across clearinghouses and payer systems to ensure claims are
• Analyze large claim populations to identify trends, bottlenecks, acceptance issues, and
• Investigate rejected, unacknowledged, delayed, or 'stuck' claims and determine root causes.
• Partner with Billing Operations, Insurance Verification, Denials Management, Coding, Configuration
• Identify opportunities to automate manual claim status workflows and improve operational efficiency.
• Serve as a subject matter expert on clearinghouse operations, payer connectivity, claim submission

🎯 Requirements

• Bachelor's degree or equivalent combination of education and experience.
• 4+ years of healthcare revenue cycle experience.
• Experience with claim submission, claim status, claim acceptance/rejection management, or EDI
• Strong understanding of healthcare claims workflows and payer processing.
• Experience researching and resolving claim transmission, acceptance, or rejection issues.
• Advanced Microsoft Excel or Google Sheets skills, including data analysis and reporting.

🎁 Benefits

• Comprehensive medical, dental, vision, life, and disability plans
• Free testing for employees and immediate family members
• Fertility care benefits
• Pregnancy and baby bonding leave
• 401(k) benefits
• Commuter benefits