EDI Coordinator en Pure Infusion Suites

Description

Position Summary:

The EDI Coordinator is responsible for managing and maintaining all electronic data interchange (EDI) activities between AdvancedMD, Waystar, and associated payers. This role ensures clean, timely, and compliant transmission of claims, remits, and eligibility files. The ideal candidate will serve as a central point of contact for EDI enrollments, troubleshooting, and transmission issues while supporting billing operations across multiple states and payers

Key Responsibilities

• Manage and monitor EDI transmissions via AdvancedMD and Waystar, including 837, 835, 999, 277CA, and eligibility (270/271) files.
• Oversee and track EDI enrollment setup and status for new and existing payers across all states.
• Investigate and resolve EDI rejections, failed batches, and clearinghouse errors.
• Liaise with payer EDI departments and Waystar support to ensure file compliance and resolution of delays.
• Work with internal billing, credentialing, and IT teams to ensure accurate mapping and payer ID usage in AMD.
• Maintain accurate documentation of payer-specific rules, enrollment timelines, and transmission processes.
• Validate that all ERA (835) files are posting correctly and reconcile any gaps in remittance data.
• Regularly review and report on EDI performance metrics, rejection rates, and trends.
• Assist in testing new file formats, NPI/tax ID enrollments, and payer migrations within AMD and Waystar.
• Maintaining quality results by strictly adhering to standards.
• Works closely with various internal departments, such as IT, sales, Intake, operations, clinical operations, and finance, to understand their EDI needs and resolve issues.

Required Knowledge and Skills

• Hands-on experience with AdvancedMD and Waystar clearinghouse systems.
• Proven ability to manage payer-specific EDI setup and escalations.
• Ensure compliance with HIPAA EDI standards and internal RCM protocols.
• Excellent written and verbal communication, especially when working with payer tech support.
• Experience with multi-state payer setups and crosswalk management in AMD.
• Working knowledge of claims workflows in infusion services or specialty clinics.
• Familiarity with ERA auto-posting logic and reconciliation.
• Experience coordinating with offshore teams or large RCM departments.

Education/Licensure/Technical Requirements.

• 5+ years of experience with EDI in a healthcare billing or RCM environment.
• High School diploma or GED
• Ability to meet U.S. employment and eligibility requirements.

Qualifications