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Remote Edi Hipaa Jobs in Alabama (NOW HIRING)

... remote position requiring strong technical skills, deep knowledge of Medicaid portals and EDI ... Ensure compliance with all state and federal regulations (including HIPAA) and maintain up-to-date ...

Remote Edi Hipaa information

What is a Remote EDI HIPAA specialist?

A Remote EDI HIPAA Specialist is a professional who manages and monitors the electronic exchange of healthcare information in compliance with HIPAA regulations, while working remotely. They ensure that electronic data interchange (EDI) transactions, such as insurance claims and patient records, are securely transferred between healthcare providers, payers, and other entities. Their role involves troubleshooting data transmission issues, maintaining data privacy and security, and ensuring all processes adhere to HIPAA standards. Strong knowledge of healthcare data formats, EDI standards, and federal privacy laws is essential in this position.

What are the key skills and qualifications needed to thrive as a Remote EDI HIPAA specialist?

To thrive as a Remote EDI HIPAA Specialist, you need in-depth knowledge of electronic data interchange (EDI), healthcare transaction sets (such as 837 and 835), and strong familiarity with HIPAA compliance requirements, often supported by a relevant degree or certification. Proficiency in EDI mapping tools, transaction monitoring systems, and healthcare management software like X12, Sterling Gentran, or similar platforms is essential. Excellent analytical skills, attention to detail, and strong communication make you stand out when troubleshooting issues and collaborating with payers or providers remotely. These skills are crucial to ensure accurate, secure, and compliant healthcare data transactions in a virtual environment.

What are some common challenges faced by Remote EDI HIPAA professionals, and how can they be managed effectively?

Remote EDI HIPAA professionals often encounter challenges such as ensuring secure data transmission, maintaining compliance with constantly evolving HIPAA regulations, and troubleshooting EDI transaction errors without onsite support. To manage these effectively, it's important to stay updated on regulatory changes, utilize secure communication tools, and develop strong documentation and troubleshooting skills. Regular communication with IT, compliance, and healthcare partners is also key to resolving issues promptly and maintaining smooth operations.

What is the difference between Remote Edi Hipaa vs Remote Medical Biller?

AspectRemote Edi HipaaRemote Medical Biller
CertificationsHIPAA compliance, EDI standardsMedical billing certifications (e.g., CPC, CPC-H)
Work EnvironmentElectronic data interchange processing, compliance-focusedBilling, coding, and insurance claim submission
Industry UsageHealthcare, insurance, EDI providersHealthcare providers, billing companies
Search/Comparison IntentFocus on HIPAA and EDI compliance rolesFocus on billing and coding tasks

Remote Edi Hipaa specialists primarily handle electronic data interchange and HIPAA compliance, ensuring secure transmission of healthcare data. Remote Medical Billers focus on submitting insurance claims and coding. While both roles work remotely in healthcare, EDI Hipaa roles emphasize data security and standards, whereas Medical Billers concentrate on billing processes and reimbursements.

What cities in Alabama are hiring for Remote Edi Hipaa jobs?

Cities in Alabama with the most Remote Edi Hipaa job openings:

DIRECTOR BILLING AND REVENUE CYCLE MANAGEMENT

Palco

Remote

Full-time

Medical, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


Job description

DIRECTOR OF BILLING AND REVENUE CYCLE MANAGEMENT


 We’re Palco. We provide the management, support, and systems behind self-directed programs—the services that help people hire, pay, and manage their own caregivers with confidence. With 25+ years of experience as a national provider operating in over 17 states, we keep people at the center of everything we do. Through innovative technology and decades of expertise, we help states and partners run stronger, more compliant, and efficient programs. Our mission is to challenge the status quo and build smarter, more human-centered solutions that put power back in people’s hands. Want to learn more about joining our team? Visit to explore opportunities.


  We are seeking a highly skilled and experienced Director of Billing and Revenue Cycle Management to oversee and optimize our Medicaid and Managed Care billing operations. The ideal candidate will have at least 3 years of experience in revenue cycle management and a track record of managing teams of 10-15 people . The Director will be responsible for day-to-day management of billing processes , ensuring timely and accurate billing, addressing claim denials, and overseeing collections. Additionally, this role requires a critical thinker who can collaborate across teams, train staff, and formalize operational procedures while maintaining a strong focus on performance metrics.


This is a remote position requiring strong technical skills, deep knowledge of Medicaid portals and EDI claims systems, and the ability to manage a growing team. The Director will work closely with payroll , client-facing teams , and IT to ensure smooth operations and resolution of billing issues.

Key Responsibilities:


  • Lead and manage a billing team  (10-15 people) in the home care space , ensuring timely and accurate billing submissions.
  • Oversee the preparation and submission of Medicaid and Managed Care claims , including 837, 835, 276, 277, 834, 270, 271, and 999 files.
  • Identify and address issues  related to claim denials, rejections, underpayments, and overpayments, ensuring claims are resubmitted as needed.
  • Develop and implement training programs  for billing staff, ensuring they are well-versed in Medicaid and Managed Care billing procedures and company policies.
  • Collaborate with cross-functional teams  (e.g., payroll, client-facing teams, MCOs) to ensure seamless billing operations and efficient resolution of billing inquiries.
  • Interface with IT teams  to troubleshoot system issues and collaborate on technical solutions related to billing and claims processing.
  • Monitor and track billing performance , ensuring collections targets are met and billing is completed timely each month.
  • Reconcile billing accounts to the general ledger  and ensure alignment between billing records and financial statements.
  • Document and formalize billing procedures  to improve efficiency, accuracy, and compliance with regulatory requirements.
  • Analyze and interpret billing data , using Excel (VLOOKUPs, pivot tables) to provide actionable insights for management.
  • Ensure compliance with all state and federal regulations (including HIPAA) and maintain up-to-date knowledge of Medicaid policies.
  • Provide leadership in staff development , fostering a high-performance culture focused on accuracy, customer service, and team growth.


Required Qualifications:


  • Advanced Excel skills are required , including proficiency with VLOOKUPs, pivot tables , and other formulas.
  • 5+ years of experience  in Medicaid billing and Managed Care programs , particularly in the home care space ideal
  • Proven experience managing a team of 10-15 billing staff , with the ability to train, develop, and motivate the team.
  • In-depth knowledge of Medicaid portals and EDI claims systems (837, 835, 276, 277, 834, 270, 271, 999).
  • Strong experience with reconciliation processes and a solid understanding of billing, payments, and general ledger alignment.
  • Ability to collaborate across departments (payroll, client-facing teams, IT, etc.) to streamline processes and resolve issues.
  • Excellent critical thinking and problem-solving skills, particularly when addressing billing discrepancies and system issues.
  • Strong training and development abilities , with experience in documenting and formalizing procedures.
  • Ability to work independently and manage a team remotely.
  • Previous experience with NetSuite or similar accounting software is a plus.



Join Us

  • This position is remote/work-from-home role. Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.


  • Company benefits designed for you:
  • Generous Paid time off.
  • Annual bonus potential.
  • Retirement Savings: We will support you as you save for your future.
  • Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
  • Paid Training: Earn while you learn and continue to grow with access to internal and external learning opportunities.
  • Great Work Environment: We are proud of our company culture of collaboration and the recognition we have received for our diversity efforts.


Benefits package:

  • Employer shared Health Insurance cost
  • Employer paid Disability Insurance
  • Employer paid Life and AD&D Insurance
  • Vision Insurance
  • Cancer Insurance
  • Voluntary Life Insurance
  • Paid Time Off
  • Remote work environment
  • Paid holidays

When you join Palco, you are engaged in creating the future - both our company’s, the people we serve, and your own. We understand that our success is directly related to the success of our team. We strive to create a culture where you can:


  • Bring your authentic self to work.
  • Grow and thrive, both personally and professionally.
  • Make a difference with our clients, in our communities, and with the millions of people we support.
  • Experience work/life balance.
  • Feel value and a greater purpose through the work you do.


Palco, Inc. is an Equal Employment Opportunity (EEO ) employer and does not discriminate in any employer/employee relations based on race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law .