VIVA HEALTH
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This role is offered by VIVA HEALTH. Your actual pay will be based on your skills and experience.
Electronic Data Interchange (EDI) Eligibility Specialist
Location:
Birmingham, AL
Base pay range $20.00/hr - $26.00/hr
Why VIVA HEALTH? VIVA HEALTH, part of the University of Alabama at Birmingham Health System, provides quality, accessible health care. Our employees are part of the communities they serve and partner with members on their healthcare journeys.
VIVA HEALTH has been recognized by 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
Tuition Assistance
Flexible Spending Accounts
Community Service Time Off
Life Insurance and Disability Coverage
Employee Wellness Program
Training and Development Programs
Employee Assistance Program
Job Description The EDI (Electronic Data Interchange) Eligibility Specialist develops and maintains existing eligibility EDI programs and other PC‑based programs for VIVA HEALTH, assisting with maintenance and execution of recurring processes surrounding eligibility business requirements.
Key Responsibilities
Carry out end‑to‑end steps to receive and transform data for loading into VIVA HEALTH’s systems.
Work closely with Finance, Operations, and Medicare departments to support enrollment functions.
Collaborate with third‑party vendors to analyze and set up appropriate processes for eligibility and claims data feeds.
Coordinate with Compliance/Legal to ensure proper documentation before data feeds are set up.
Required Qualifications
Bachelor’s degree or equivalent work experience.
1–3 years of experience with database technology/process management.
Demonstrated experience owning processes.
Excellent interpersonal, verbal and written communication skills.
Excellent attention to detail and accuracy.
Knowledge of MS Access.
Preferred Qualifications
3–5 years of experience with database technology/process management.
Experience with MS SQL.
Microsoft and/or PMI certifications.
Understanding of the relationship between health plan eligibility and premium accounting.
Knowledge of ANSI ASC 5010/834 file formats.
Knowledge of HIPAA and ACA.
Seniority level Associate
Employment type Full‑time
Job function Information Technology, Administrative, Accounting/Auditing.
Industries Insurance, Hospitals and Health Care.
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This role is offered by VIVA HEALTH. Your actual pay will be based on your skills and experience.
Electronic Data Interchange (EDI) Eligibility Specialist
Location:
Birmingham, AL
Base pay range $20.00/hr - $26.00/hr
Why VIVA HEALTH? VIVA HEALTH, part of the University of Alabama at Birmingham Health System, provides quality, accessible health care. Our employees are part of the communities they serve and partner with members on their healthcare journeys.
VIVA HEALTH has been recognized by 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
Tuition Assistance
Flexible Spending Accounts
Community Service Time Off
Life Insurance and Disability Coverage
Employee Wellness Program
Training and Development Programs
Employee Assistance Program
Job Description The EDI (Electronic Data Interchange) Eligibility Specialist develops and maintains existing eligibility EDI programs and other PC‑based programs for VIVA HEALTH, assisting with maintenance and execution of recurring processes surrounding eligibility business requirements.
Key Responsibilities
Carry out end‑to‑end steps to receive and transform data for loading into VIVA HEALTH’s systems.
Work closely with Finance, Operations, and Medicare departments to support enrollment functions.
Collaborate with third‑party vendors to analyze and set up appropriate processes for eligibility and claims data feeds.
Coordinate with Compliance/Legal to ensure proper documentation before data feeds are set up.
Required Qualifications
Bachelor’s degree or equivalent work experience.
1–3 years of experience with database technology/process management.
Demonstrated experience owning processes.
Excellent interpersonal, verbal and written communication skills.
Excellent attention to detail and accuracy.
Knowledge of MS Access.
Preferred Qualifications
3–5 years of experience with database technology/process management.
Experience with MS SQL.
Microsoft and/or PMI certifications.
Understanding of the relationship between health plan eligibility and premium accounting.
Knowledge of ANSI ASC 5010/834 file formats.
Knowledge of HIPAA and ACA.
Seniority level Associate
Employment type Full‑time
Job function Information Technology, Administrative, Accounting/Auditing.
Industries Insurance, Hospitals and Health Care.
#J-18808-Ljbffr