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, Cutting-edge 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,

📌 EDI Specialist (Mumbai)
🏢 Harris Computer
📍 Mumbai