Hiring: EDI Specialist Company: Core Clinical Partners Location: Lafayette, LA Job Posted Time: 2026-09-11 10:17:27 Employment Type: Hybrid Target Skills & Keywords : HIPAA, Regulatory Compliance, SQL, Segment About the job Experience: •4+ years in EDI analytics, implementation, or healthcare revenue cycle management. •Proficiency in EDI standards, HL7, mapping (STTM), and integration tools; experience with payer, claims, benefits, and care management systems. •Microsoft Excel experience in analyzing and organizing large volumes of data for trending/exception reporting. •Hybrid, preferred. If hybrid, the employee should be in the office a minimum of 3 days per week. The employee must have reliable access to internet when working remotely. Required Skills: •Serve as the organizational subject matter expert for all EDI-related processes, technologies, and electronic transaction workflows. •Administer and maintain payor enrollments for Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT), ensuring timely implementation and ongoing accuracy. •Monitor and optimize ERA enrollment performance to maintain a target of 95% or greater electronic payment posting across all eligible payors. •Manage user access and security for payor portals, clearinghouses, and other electronic transaction platforms, ensuring appropriate governance and compliance. •Monitor EDI transaction activity and proactively identify, troubleshoot, and resolve transmission failures, processing errors, and connectivity issues. •Oversee clearinghouse performance, including claim transmission, payer routing, edit management, acknowledgements, and transaction acceptance rates. •Analyze claim exceptions, rejections, and electronic edit trends to identify root causes and implement scalable, long-term solutions that improve first-pass claim acceptance. •Evaluate payor configurations and billing system setup to ensure accurate electronic routing, reduce technical denials, and improve payment turnaround times. Qualifications: •Bachelor’s Degree in Information Technology, Computer Science or related field preferred but not required. Compensation: •Deep knowledge and understanding of professional claims processing and adjudication in the healthcare and health insurance industry Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!