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Edi 837 Jobs in Florida (NOW HIRING)

Kavaliro

EDI Developer

Orlando, FL · On-site

Design and support SFTP based inbound/outbound integrations for large flat files (837/835 ... EDI/X12 processing using EdiFabric or equivalent EDI toolkits * X12 transaction pipelines (837, 835 ...

Zelis

EDI Analyst

Saint Petersburg, FL · On-site

... 837, 834, and 270/271 is a plus. * Strong understanding of the healthcare claims lifecycle, payment processing, provider payment posting, and reconciliation. * Experience with EDI validation tools ...

The Legacy Companies

EDI Manager

Fort Lauderdale, FL · On-site

EDI Manager Position The Legacy Companies (TLC) is seeking an experienced, hands-on EDI Manager to provide immediate leadership to our EDI function. This role is responsible for taking charge of our ...

The Legacy Companies, LLC

EDI Manager

Weston, FL · On-site

This role is responsible for taking charge of our existing EDI team, establishing clear communication and accountability, and rapidly diagnosing and resolving the bottlenecks currently slowing ...

Atria Group LLC

EDI Analyst

Jacksonville, FL

Maintain and expand the client's EDI/B2B environment. Analyze all incoming requests and determine a comprehensive solution. Ensure that all EDI traffic is secured and performing at peak capacity.

Icwgroup

EDI Administrator

Orlando, FL · On-site

Documents and maintains procedures on the various components of EDI reporting. * Gains an understanding of the policies, procedures, and operations of the various reporting entities, including ...

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Edi 837 information

What is an EDI 837?

An EDI 837 is an electronic data interchange (EDI) transaction set used by healthcare providers to submit healthcare claim information to payers, such as insurance companies. The 837 form replaces traditional paper claim forms and streamlines the process of billing for medical services. It ensures that claims are transmitted securely, accurately, and in a standardized format, which helps reduce errors and speeds up reimbursement. There are different types of 837 transactions, including those for institutional, professional, and dental claims.

What are the key skills and qualifications needed to thrive as an EDI 837 specialist, and why are they important?

To thrive as an EDI 837 Specialist, you need a strong understanding of healthcare claims processing, EDI transaction sets (especially 837), and knowledge of HIPAA regulations, often supported by experience in healthcare IT or revenue cycle management. Familiarity with EDI translation software, clearinghouse platforms, and mapping tools like Sterling B2B Integrator or Edifecs is typically required. Strong analytical skills, attention to detail, and effective communication are essential soft skills for troubleshooting issues and collaborating with providers and payers. These skills ensure accurate and compliant transmission of healthcare claim data, minimizing errors and optimizing reimbursement cycles.

What are some common challenges faced by professionals working with EDI 837 transactions, and how can they be addressed?

Professionals working with EDI 837 transactions often encounter challenges such as ensuring data accuracy, managing compliance with HIPAA regulations, and troubleshooting rejected claims due to syntax or mapping errors. Staying updated with payer-specific requirements and understanding the nuances of healthcare claim data are crucial to minimize errors. Collaborating closely with IT, billing, and compliance teams can help resolve issues quickly and maintain smooth claim submissions. Regular training and leveraging robust EDI validation tools are also key strategies for overcoming these challenges.

What is the difference between Edi 837 vs Medical Billing Specialist?

AspectEdi 837Medical Billing Specialist
Primary RoleElectronic submission of healthcare claimsProcessing and managing healthcare billing and claims
Required SkillsKnowledge of EDI standards, coding, and claim submissionBilling procedures, coding, insurance verification
Work EnvironmentHealthcare providers, insurance companies, billing servicesMedical offices, billing companies, healthcare facilities
CertificationsOften requires knowledge of EDI standards, coding certificationsMedical billing certifications (e.g., CPC, CBCS)

While Edi 837 focuses on the electronic transmission of healthcare claims using specific standards, the Medical Billing Specialist handles the overall billing process, including claim submission, follow-up, and insurance communication. Both roles are essential in healthcare revenue cycle management but differ in scope and technical focus.

What are popular job titles related to Edi 837 jobs in Florida?

For Edi 837 jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Edi 837 jobs in Florida look for?

The top searched job categories for Edi 837 jobs in Florida are:

What cities in Florida are hiring for Edi 837 jobs?

Cities in Florida with the most Edi 837 job openings:

Edi 837 jobs near you
Infographic showing various Edi 837 job openings in Florida as of August 2026, with employment types broken down into 87% Full Time, 3% Part Time, and 10% Contract. Highlights an 82% Physical, 6% Hybrid, and 12% Remote job distribution.

EDI Encounter Specialist

Doctors HealthCare Plans, Inc.

Coral Gables, FL • On-site

$65 - $90/hr

Other

Re-posted 13 days ago

Key responsibilities

  • Monitor daily encounter file processing and submission activities.

  • Validate encounter data prior to submission to ensure completeness and accuracy.

  • Research and resolve rejected encounters from AHCA, CMS, or clearinghouses.

Job description

The EDI Encounter Specialist is responsible for the administration, monitoring, validation, and support of healthcare encounter data submitted to state (AHCA) and CMS, as well as those received from clearinghouses and business partners. This position ensures encounter data is complete, accurate, compliant, and submitted within required regulatory timeframes.

The specialist works closely with Claims, IT, Compliance, Finance, Vendor Management, and external vendors to identify, research, and resolve encounter submission issues while maintaining compliance with CMS, AHCA, HIPAA, and ANSI X12 standards.

Essential Responsibilities:
  • Monitor daily encounter file processing and submission activities.
  • Validate encounter data prior to submission to ensure completeness and accuracy.
  • Research and resolve rejected encounters from AHCA, CMS, or clearinghouses.
  • Analyze encounter acceptance and rejection reports to identify trends and root causes.
  • Coordinate resubmission of corrected encounter records.
  • Perform reconciliation between claims adjudication systems and submitted encounter.
  • Work with business users and IT to resolve data quality issues.
  • Ensure encounter submissions comply with CMS, AHCA, HIPAA, and organizational.
  • Maintain submission schedules and regulatory deadlines.
  • Assist with implementation and testing of encounter-related system enhancements.
  • Document business processes, procedures, and issue resolutions.
  • Support audits and regulatory requests related to encounter data.
  • Participate in production support and issue resolution activities.
Healthcare EDI Responsibilities:
  • Support and troubleshoot HIPAA transactions including: 837 Professional (837P), 837 Institutional (837I), 837 Dental (837D), 999 Functional Acknowledgments, TA1 Interchange Acknowledgments, 277CA Claim Acknowledgments, 835 Electronic Remittance Advice (preferred) and 275 Attachments (preferred).
Encounter Data Responsibilities:
  • Validate encounter records prior to submission.
  • Monitor encounter acceptance and rejection rates.
  • Research front-end and back-end validation errors.
  • Coordinate corrections with Claims, Configuration, and IT teams.
  • Perform monthly encounter reconciliation.
  • Support encounter attestation processes.
  • Track encounter inventory and aging.
  • Maintain encounter dashboards and operational metrics.
  • Analyze recurring rejection patterns and recommend corrective actions.
  • Participate in user acceptance testing (UAT) for encounter enhancements.
Required Qualifications:
  • Bachelor's degree in Information Systems, Healthcare Administration, Computer Science, Business, or equivalent experience.
  • 3–5 years of healthcare EDI or encounter management experience.
  • Experience working with healthcare claims and encounter data.
  • Knowledge of HIPAA X12 transaction standards.
  • Strong analytical and problem-solving skills.
  • Excellent written and verbal communication skills.
Preferred Qualifications:
  • Experience submitting encounters to CMS, AHCA, or state Medicaid agencies.
  • Experience with Edifecs, Health Suite.
  • Knowledge of healthcare regulatory requirements.
Typical Daily Activities:
  • Monitor overnight encounter processing.
  • Review encounter acceptance and rejection reports.
  • Research failed submissions and coordinate corrections.
  • Execute SQL queries for reconciliation and validation.
  • Work with Claims and IT to resolve data issues.
  • Track encounter inventory and aging.
  • Update operational dashboards.
  • Participate in production support meetings.
  • Coordinate vendor and clearinghouse communications.
  • Prepare regulatory submission status reports.

Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP

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