We are committed to offering superior human resource tools to Brokers and Employers.
EDI Coordinator
Location
United States
Posted
4 hours ago
Salary
0
Seniority
Senior
Job Description
EDI Coordinator
HR Tech Solutions
• EDI Coordinator will be responsible for managing discrepancy reports for 834 file feeds • Review daily carrier reports and triage member and technical discrepancies • Investigate issues and route to carrier, broker and/or create a technology case • Answer system related questions from a variety of companies with multiple benefit plans and levels • Other duties as assigned
Job Requirements
- Must have a minimum of 2-3 years experience in employee benefits and understand all types of plans and the relationship between the broker and human resources
- Must have worked with an online benefit administration in a previous position for at least two (2) years- preferably with Employee Navigator, Ease Bswift, Plansource or Zenefits
- Must be analytical & detail oriented
- Must have excellent customer service skill and flexibility
- Must be able to handle multiple projects at one time at a fast pace with minimal errors
Benefits
- Fully Remote
Related Guides
Related Categories
Related Job Pages
More General Jobs
• Lead activities and excursions for international students • Organising and running afternoon activities for students • Take groups on pre-arranged excursions via coach each Sunday
• Recruit host families for students attending public high school in local community • Connect students with host families within your community and supervise those students throughout their stay • Act as a mediator and advocate for the student • Reach out to the student, host family, and school on a regular basis to discuss recent experiences and compile a monthly progress report • Participate in community outreach and recruitment of host families
ALF Care Coordinator
LibertanaLibertana is a revolutionary home health care agency providing families with exceptional medical and non-medical care.
• The Assisted Living Waiver Program Care Coordination Agency (ALWP CCA) Office Coordinator is responsible for processing the ALWP beneficiary application as per Regulatory Agency and Libertana Home Health Policy. • Assists Medi-Cal beneficiaries in obtaining access to waiver services, state plan services and other community resources by identifying, coordinating and collecting data required for the ALWP application. • Responsible for the proper completion of all documents required for the State Waiver Program Application as per ALWP and Agency policy. • Reviews and evaluates the ALWP documents necessary for State Waiver Program Application, including Initial Assessments, Re-assessments, ISPs, Physicians Reports Medi-Cal eligibility, etc. • Discusses State inquiries or requests for documentation with Lead ALF Coordinator, ALF Manager, ALF Staff, SNFs and other referral sources. • Responsible for the completion of Patient Charts as per Agency policy. • Establishes and maintains good relationships with RCFE, SNFs and other vendors. • Assists the Agency in maintaining compliance with Federal, State, Local and HIPAA Regulations or Joint Commission Standards. • Assists facilities and ALF Care Coordinators in Habilitation Hours compliance. • Assures that assessments are performed and all necessary documents are completed. • Troubleshoots Client, RCFE, SNF and other vendor issues. • Follow up with RCFE managers, discharge planners and other appropriate client contacts who work there, establishing working relationships and educating them about the ALW Program the services available to them. • Exercises excellent judgement and knowledge of current ALF Care Coordination practices and procedures in alignment with Libertana Policy and DHCS ALWP Policy. • Participates in appropriate continuing education as may be required and/or required by your immediate supervisor. • Maintains a comfortable work environment for all employees. • Conforms to all agency policies and procedures. • Respects the patients and familys rights and property as defined by the federal and state laws. • Driving may be required to geographical areas that are covered by the company. • Knowledge of Confidentiality, HIPAA and healthcare laws and regulations. • Reports Fraud and Abuse. • Knowledge of mandated reporting. • Performs other duties as assigned.
Medi-Cal Eligibility Resolution Specialist
LibertanaLibertana is a revolutionary home health care agency providing families with exceptional medical and non-medical care.
• Investigate and resolve Medi-Cal eligibility barriers that prevent members from accessing services or disrupt reimbursement workflows • Conduct eligibility verification using state systems, EMR platforms, and insurance databases • Communicate with county eligibility workers to clarify case status and resolve pending or denied actions • Oversee and coordinate Medi-Cal redetermination submissions • Track redetermination cycles and proactively engage members • Contact members to gather required information and explain eligibility requirements • Build relationships with county Medi-Cal offices • Collaborate with internal departments including Member Services, Revenue Cycle, Clinical Teams, and Compliance • Maintain accurate, audit-ready documentation • Conduct in-person visits to county offices when necessary • Track and report eligibility trends and case outcomes • Driving will be required to county offices • Maintain confidentiality, HIPAA compliance, and knowledge of mandated reporting requirements • Uphold agency standards, policies, and procedures as outlined in the Employee Handbook • Participate in departmental meetings and trainings as required • Performs other duties as assigned


