MedVanta is a physician-owned and operated management services organization (MSO) serving musculoskeletal providers. The organization supports a collaborative, employee-centered culture focused on diversity, inclusion, and professional growth.
The EDI Specialist manages daily claim submission workflows to ensure claims are transmitted accurately and accepted by clearinghouses and payers in a timely manner. This role monitors electronic and paper claim submissions, resolves clearinghouse and payer front-end rejections, and supports proper coordination of benefits for primary, secondary, and tertiary claims. The position works closely with billing, registration, coding, and authorization teams to correct claim errors, address rejection trends, and support efficient front-end revenue cycle operations.
High school diploma or GED required; bachelor's degree in Business Administration, Healthcare Administration, or Electronic Data Management preferred.
Electronic Data Interchange (EDI) certification strongly preferred.
Strong understanding of claim basics, including subscriber vs. patient, provider types, NPI/taxonomy, place of service, ICD-10/CPT/HCPCS, authorizations/referrals, coordination of benefits, payer IDs, and routing.
Ability to navigate PM systems, clearinghouse portals, payer websites, and workqueues efficiently.
Experience with high-volume multi-site physician group billing.
Familiarity with ANSI X12 concepts such as 837P, 835, and 276-277, and with clearinghouse tools.
Experience with ModMed/mmPM, Trizetto, Waystar, Change Healthcare, Availity, or similar tools preferred.
Proficiency with Microsoft Office and standard office software.
Strong time management, organizational, multitasking, and communication skills.
Ability to work independently and collaborate effectively across teams.
Must be able to read, write, speak, understand, and communicate clearly in English.
Medical, dental, and vision insurance
Flexible Spending Account (FSA) and Health Savings Account (HSA) options
401(k) retirement plan with employer contributions
Paid time off and paid holidays
Employer-paid life insurance
Voluntary supplemental benefits, including disability and additional coverage options
Employee Assistance Program (EAP)
Location
Maryland, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago