Healthcare EDI Payer Connectivity Specialist

Healthcare EDI Specialist – Connect Our Clearinghouse to Insurance Payers We've built an EHR, medical billing system and our own clearinghouse, and we need an experienced US healthcare EDI specialist to connect the clearinghouse directly to insurance payers. You'll lead trading partner enrollment and certification with Medicare MACs, state Medicaid programs, payer gateways such as Availity and Optum, and major commercial payers. You'll also set up the connections (SFTP, AS2 or API) and validate our X12 5010 transactions: 837, 835, 270/271, 276/277, 999 and 277CA. For payers that won't accept a direct connection, you'll help us set up connections through partner clearinghouses. The project runs through payer testing and go-live, and ends with documentation of each payer connection. You should have at least 3 years of hands-on payer connectivity experience at a clearinghouse, payer or large billing company, including direct trading partner enrollment with payers, and a strong understanding of HIPAA. Experience with clearinghouse accreditation (EHNAC/ACHC) and Medicare MAC submitter enrollment is a big plus. The project is [fixed price / hourly], with a budget of [$X–$Y] over about [timeline]. You'll sign an NDA and a BAA before starting. In your proposal, list the payers you've set up direct connections with and give your estimated timeline and cost. Please start your proposal with the word "5010."