EDI Consultant, Healthcare
Posted 12 days ago
You'll complete your application on Vector Outsourcing Solutions Philippines's career site.
About the Role
In this position, you will serve as a key member of our healthcare team, acting as a liaison between clinical data and revenue cycle processes. You will be responsible for overseeing the electronic data interchange systems that facilitate essential communication between healthcare providers, insurance companies, and clearinghouses. By joining our team, you will focus on improving billing efficiency, resolving technical submission issues, and maintaining the accuracy and regulatory compliance of medical claims. This remote role operates in a high-speed environment where your technical expertise will drive client success. You will manage everyday EDI functions, analyze intricate data sets, and lead the integration of new accounts to ensure billing workflows and digital interfaces operate correctly.
Requirements
- You should have a minimum of two years of professional experience in medical billing, claims management, or Healthcare EDI.
- You must demonstrate a thorough knowledge of EDI processes, submission standards, clearinghouse functions, and methods for addressing rejected claims.
- You are expected to be familiar with insurance payer operations, claim validation rules, and various reimbursement workflows.
- It is highly preferred that you are proficient in using EMR or EHR platforms and medical billing applications.
- This position requires strong organizational, analytical, and problem-solving capabilities, as well as superior communication skills to work effectively across departments.
- You must possess a keen eye for detail to thrive in this high-volume workplace and commit to a contract duration of at least six months.
Responsibilities
- You will be responsible for transmitting medical claims to clearinghouses and tracking both electronic and paper-based transactions to guarantee payment precision.
- Your tasks involve documenting submission records, fixing and investigating rejected claims, and organizing testing phases for new EDI setups.
- You will track daily EDI metrics by examining complex data to find and rectify recurring error trends.
- You will also manage the onboarding process for new clients, oversee file exchanges, maintain data consistency across systems, and balance incoming charges against EDI submissions.
- You will keep current on evolving payer regulations and legal standards to maintain process compliance, while reporting difficult technical problems to management.
Benefits & Perks
- You will receive a company-issued computer for your home office.
- Leave benefits include paid sick, vacation, bereavement, and maternity or paternity leave.
- The package includes paid public holidays and mandatory government contributions, including Philhealth, Pag-ibig, and SSS.
- You will be entitled to a 13th-month salary, a night shift premium where applicable, and a monthly de minimis benefit of Php 1,000.
- Upon achieving regularized status, you will receive a Php 1,000 monthly bonus and access to health insurance via an HMO.
Note: This listing is summarized and paraphrased by WorkNow from a publicly posted role. For the original wording and full details, please refer to the employer's official posting.
Similar Jobs
Inpatient Coding Supervisor – Mid-Shift
Med-Metrix
This leadership position is centered on leading and refining the output of an inpatient coding group. In this virtual capacity, you will handle daily functions to guarantee that output and precision goals are hit on a regular basis. You will act as a primary point of contact, handling task lists, verifying that Service Level Agreements are respected, and assigning tasks based on coder availability and account urgency. By building a supportive setting, you will be instrumental in upholding superior performance standards and assisting with the career growth of your personnel. Furthermore, you will focus on increasing efficiency and ensuring regulatory adherence within the unit. Your duties involve tracking performance indicators, performing routine evaluations, and working alongside quality control groups to resolve error patterns and launch correction methods. You will also participate in workflow enhancements, assist with automation programs, and ensure your staff stays current with changing coding mandates. Using analytical findings and consistent communication with management and client partners, you will guarantee that every inpatient coding task is performed with accuracy, honesty, and a dedication to excellence.
Freelance Website Developer, Graphic Designer
Pramira
We are looking for a multi-talented freelance Web Developer and Graphic Designer to work remotely. This position suits a creative expert who can integrate technical web work with superior visual design. Your main tasks include managing our WordPress presence to keep the site fast, secure, and attractive, while also creating various marketing materials. You will assist multiple departments by delivering custom design solutions that match our standards in the telecommunications and engineering sectors. This role provides great flexibility, as you can organize your own hours within a freelance structure. You will partner with our team to run marketing initiatives, keep branding consistent across all channels, and complete various digital and print production assignments. We need someone who can work autonomously, communicate effectively, and document their hours, making this a great fit for a self-driven person interested in varied project work.
Senior Art Director
Construct Digital
This agency focuses on building data-backed brand stories that produce tangible commercial success. Through a mix of artistic flair and sophisticated technical solutions, the firm drives growth in sales, lead acquisition, and ROI. The service offering includes data analysis, UX design, content marketing, and modern AI integration to optimize engagement and performance. As a Senior Art Director, you will work alongside creative technologists, planners, and strategists to deliver impactful solutions for clients throughout the Asia-Pacific territory. This pivotal position requires a blend of aesthetic leadership, hands-on production, and strategic guidance within an environment that promotes experimentation and continuous workflow improvement.