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., EDI Enrollment & Configuration

• 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.

Implementation Support

• 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.

Issue Resolution

• 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.

Documentation & Testing

• 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.

Success Measures

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

To ensure we retain and invest in great people, AMSURG provides its employees with the benefits, recognition, training, and opportunities needed for professional growth. Our wide range of health and welfare benefits allow you to choose the right coverage for you and your family. AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.

Paid Time Off:

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.

Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com., Employment at AMSURG: Living Our Values Every Day At AMSURG, our values define who we are and how we serve our patients, partners, and each other. As a national leader in ambulatory surgery, we are committed to a culture of excellence, integrity, teamwork and caring deeply. Our values guide every decision, ensuring we continue to elevate healthcare and provide the highest quality care. These guiding principles are the foundation of our culture and a guide to how we collaborate, innovate, and make a difference every day.