About the role
Business Unit:
Resolv was formed in 2022, bringing together a suite of industry-leading healthcare revenue cycle leaders with over 30 years of industry expertise, including Ultimate Billing, First Pacific Corporation, Innovative Healthcare Systems, and Innovative Medical Management. Our DNA is rooted in revenue cycle solutions. As we continue to expand, we remain dedicated to partnering with RCM companies that offer diverse solutions and address today's most pressing healthcare reimbursement and revenue cycle operations complexities. Together, we improve financial performance and patient experience, helping to build sustainable healthcare businesses.
Key Responsibilities:
Manage end-to-end EDI transactions (837, 835, 270/271, 276/277, 278) for claims and remittances.
Onboard and manage payers and clearinghouses; ensure EDI compliance and testing.
Analyze and resolve transaction errors, rejections, and denials.
Oversee EDI integration with billing and EHR/PM systems.
EDI profiles understanding data elements, segments, and loops within an EDI file are structured and interpreted.
Setting up new clients
Insurance Master Import. EDI configuration setup (SFTP and BIZUDS).
SFTP notifications (SFTP blocking). Monitoring EDI folders for pending files.
Billing Sanity check for Upgraded/shifted RCM Clients. Claims (EDI837/837i) related issue.
Eligibility Issues (EDI270 and EDI271). Acknowledgements EDI997 and EDI277 Issues.
Remittances EDI835 issue and resolution.
Resolution on Rejections and Denial issues.
Coordination with Clearinghouses.
Patient Statement Setup.
Resolv RCM Client Termination Process.
Coordinate with the engineering team regarding problems and enhancements.
Miscellaneous Activities.
Qualifications:
Bachelor’s degree in IT, Healthcare, or related field.
5–7 years of healthcare EDI experience with RCM exposure.
Knowledge of HIPAA, X12 transaction sets, and payer workflows.
Strong problem-solving, communication, and vendor management skills.
Work Mode: Office Hybrid
Shift Timings: 6pm-3am (Night Shift)
Location: Mumbai(Vikhroli)
Skills/ Behavioural Skills:
Problem-Solver: Identifies and resolves healthcare billing discrepancies.
Organized: Manages high volumes of medical remittances efficiently.
Clear Communicator: Effectively discusses payment issues with healthcare teams.
Analytical: Understands healthcare financial data and denial patterns.
Benefits:
Annual Public Holidays as applicable
30 days total leave per calendar year
Mediclaim policy
Lifestyle Rewards Program
Group Term Life Insurance
Gratuity
...and more!
Aplyr's read
Harris Computer excels in delivering specialized software solutions for diverse sectors, attracting tech-savvy professionals passionate about innovation and operational efficiency.
What's promising
- •Harris Computer offers diverse roles across various sectors, enhancing career growth opportunities.
- •The company focuses on innovative technology solutions, appealing to those interested in cutting-edge software development.
- •Remote work options are available, providing flexibility for employees in different roles.
What to watch
- •Limited public information about company culture and work-life balance.
- •The company's focus on multiple industries may dilute specialization in any single sector.
- •Potential challenges in maintaining consistent innovation across diverse software solutions.
Why Harris Computer
- •Harris Computer's specialization in public sector and utilities software differentiates it from general tech firms.
- •The company offers roles in emerging fields like AI, reflecting a commitment to future technologies.
- •Harris Computer's focus on operational efficiency solutions provides a niche appeal to process-oriented professionals.
Aplyr’s read is generated by AI from public sources. Was it useful?
About Harris Computer
Harris Computer is a leading provider of software solutions for various industries, including public sector, utilities, and healthcare. The company focuses on delivering innovative technology solutions to improve operational efficiency.
