Job description
Responsibilities
The Electronic Data Interchange Specialist is responsible for technical and/or professional claim submissions to all insurance companies, including TPL accounts. The specialist will need to monitor and perform research on unbilled accounts, resolve system edits, and have a good understanding of Clearinghouse responses and be able to resolve rejections. Effectively communicate with the appropriate departments and external customers in order to ensure clean claim submission.The specialist will have a thorough knowledge of billing requirements for paper and electronic claim submissions in order to receive payment for services rendered. The EDI specialist requires an understanding of various insurance plans, and payer claim requirements. The Electronic Data Interchange Specialist reports directly to the Electronic Data Interchange Supervisor.
Preferred Hospital Claims and Billing Experience.
#LP
#MP
Qualifications
Education Requirements
Experience
Required Skills
The Electronic Data Interchange Specialist is responsible for technical and/or professional claim submissions to all insurance companies, including TPL accounts. The specialist will need to monitor and perform research on unbilled accounts, resolve system edits, and have a good understanding of Clearinghouse responses and be able to resolve rejections. Effectively communicate with the appropriate departments and external customers in order to ensure clean claim submission.The specialist will have a thorough knowledge of billing requirements for paper and electronic claim submissions in order to receive payment for services rendered. The EDI specialist requires an understanding of various insurance plans, and payer claim requirements. The Electronic Data Interchange Specialist reports directly to the Electronic Data Interchange Supervisor.
Preferred Hospital Claims and Billing Experience.
#LP
#MP
Qualifications
Education Requirements
- High School Diploma - OR - GED - Relevant experience may be considered in lieu of education
Experience
- Relevant Experience
Required Skills
- Analytical Skills
- Collaborative Skills
- Computer Skills to include use and navigation
- Customer Service Skills
- Detail Oriented
- Excellent Communications Skills
- Excellent Interpersonal Skills
- Keyboarding
- Listening Skills
- Microsoft Excel
- Organizational Skills
- Problem Solving Skills
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