EDI Specialist

The EDI Specialist I supports the implementation, configuration, enrollment, and maintenance of Electronic Data Interchange (EDI) processes for ambulatory surgery centers and physician practices. This role is responsible for executing standard payer enrollments, maintaining configuration data, monitoring claim activity, and providing first-level troubleshooting support under established procedures and guidance.

The EDI Specialist I develops foundational expertise in revenue cycle management systems, payer connectivity, and clearinghouse operations while contributing to successful implementations and operational stability.

• Complete standard clearinghouse and payer enrollment activities.
• Assist with establishing payer connectivity for implementations.
• Maintain billing system configuration data including:
• Payer master files
• Provider records
• Libraries
• Electronic and paper claim setup
• Monitor enrollment progress and escalate delays or issues.

• Participate in implementation discovery and data gathering activities.
• Support project build tasks according to established standards.
• Assist with post-go-live monitoring of claims and electronic remittance activity.
• Document implementation activities and outcomes.

• Perform initial analysis of payer rejections and clearinghouse errors.
• Resolve routine claim submission and ERA issues.
• Escalate complex payer or configuration issues appropriately.
• Support Service Desk and operations teams with EDI-related inquiries.

• Maintain process documentation and user guides.
• Participate in testing activities within non-production environments.
• Validate build accuracy and identify potential issues.

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily.  The requirements listed below are representative of the knowledge, skills and/or abilities required.

• Basic understanding of healthcare revenue cycle processes.
• Working knowledge of EDI transactions including 837 and 835.
• Understanding of payer enrollment workflows.
• Strong analytical and organizational skills.
• Effective written and verbal communication skills.
• Ability to learn technical systems quickly.
• Strong attention to detail and follow-through.

• Associate degree or equivalent combination of education and experience.
• 1-3 years of experience in:
• Experience with practice management systems preferred.
• Exposure to clearinghouses and payer enrollment processes preferred.

• Timely completion of enrollments.
• Accurate configuration maintenance.
• Effective resolution of routine EDI issues.
• Achievement of implementation milestones.
• High-quality documentation and testing support.

AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information or any other status protected under applicable federal, state, or local laws. We strive to also provide a disability inclusive application and interview process. If you are a candidate with a disability and require reasonable accommodation in order to submit an application, please contact us at: careers@amsurg.com. Please include your full name, the role you’re applying for and the accommodation necessary to assist you with the recruiting process.