Electronic Data Interchange (EDI) Eligibility Specialist
Location : Birmingham, AL
Why VIVA HEALTH?
VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.
VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.
Benefits
- Comprehensive Health, Vision, and Dental Coverage
- 401(k) Savings Plan with company match and immediate vesting
- Paid Time Off (PTO)
- 9 Paid Holidays annually plus a Floating Holiday to use as you choose
- Tuition Assistance
- Flexible Spending Accounts
- Healthcare Reimbursement Account
- Paid Parental Leave
- Community Service Time Off
- Life Insurance and Disability Coverage
- Employee Wellness Program
- Training and Development Programs to develop new skills and reach career goals
- Employee Assistance Program
See more about the benefits of working at Viva Health -
Job Description
The EDI (Electronic Data Interchange) Eligibility Specialist will develop and maintain existing eligibility EDI programs and other PC-based programs for VIVA HEALTH. This position will assist with the maintenance and execution of recurring processes surrounding eligibility business requirements.
Key Responsibilities
Carry out the end-to-end steps to receive and transform data to be loaded into VIVA HEALTH’S systems.Work closely with the Finance, Operations, and Medicare departments to support their respective business functions surrounding enrollment.Work with third party vendors to analyze and setup appropriate processes for eligibility and claims data feeds from VIVA HEALTH’S systems.Work with the Compliance / Legal departments to ensure proper documentation is in place before data feeds are setup.REQUIRED QUALIFICATIONS :
Bachelor’s Degree1- 3 years’ experience with database technology / process managementDemonstrated experience with successful ownership of processesExcellent interpersonal skills for frequent interaction with users, managers, and vendorsExcellent verbal and written communications skillsExcellent attention to detail and accuracyKnowledge of MS AccessPREFERRED QUALIFICATIONS :
3 – 5 years’ experience with database technology / process managementExperience with MS SQLHealth Plan experienceMicrosoft and / or PMI certificationsUnderstanding of the relationship between health plan eligibility and premium accountingKnowledge of ANSI 5010 834 file formatsKnowledge of HIPAA and ACAEqual Opportunity Employer
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