EDI claims Specialist I
Company Description MedPOINT Management (MPM) provides customized managed care management, development, and consulting services to Independent Practice Associations (IPAs) and hospital clients. Founded in 1987, MPM supports over 4,000 contracted providers throughout California, coordinating care for more than 950,000 members across various health plans, including Commercial HMO/PPO, Medi-Cal, and Medicare Advantage. With a focus on efficiency and innovation, MPM leverages advanced IT systems to track and improve utilization, quality metrics, and health outcomes. MPM is committed to delivering high-quality, cost-effective healthcare management services tailored to the unique needs of each client. As the healthcare industry evolves, MPM remains dedicated to flexibility, innovation, and adding value for clients and members. Role Description This is a full-time, on-site role for an EDI Claims Specialist I, located in Soddy-Daisy, TN. The EDI Claims Specialist will be responsible for handling Electronic Data Interchange (EDI) transmissions, resolving claim processing issues, and working with internal and external stakeholders to ensure accurate and efficient claim submissions. Daily tasks include troubleshooting errors, analyzing data, supporting business processes, and providing exceptional customer service to address inquiries and resolve claims-related concerns. Qualifications Strong Analytical Skills and a detail-oriented mindset to identify and resolve issues efficientlyProficiency in Electronic Data Interchange (EDI) processes for claims submission and managementExpertise in Troubleshooting and resolving errors related to data entry, system issues, and claims processingAbility to provide excellent Customer Service and support to clients and internal teamsUnderstanding of Business Processes and workflows related to claims and healthcare administrationKnowledge of healthcare claims systems and experience with managed care is preferredStrong communication and problem-solving skillsProficiency using relevant computer systems and toolsHigh school diploma or equivalent required; an associate’s or bachelor’s degree is a plus