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Electronic Data Interchange Specialist

$15/hr Starting at $30

Responsible for the daily submission of insurance claims for assigned clients to all government agencies and third-party payers. Corrects system edits and payer rejections. Utilizes knowledge of the revenue cycle and patient accounts to ensure claims are submitted in a timely manner. Has regular contact with internal and external customers and does require regular outreach to payers for additional clarification related to claim status. Performs claim research and analysis to resolve claim edits daily related to responses from the payer rejection reports. Uses RealMed, Availity and Payer Web Portals with respect to claim errors, provider enrollment, patient eligibility and claims status utilizing proper customer service protocol. Ensures compliance with HIPAA protocol. Ensures claims are processed and confirmed electronically as well as drop claims to paper when needed. Assess accounts to determine the next appropriate course of action in line with company policies and protocols. Update patient insurance and demographic information.

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$15/hr Ongoing

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Responsible for the daily submission of insurance claims for assigned clients to all government agencies and third-party payers. Corrects system edits and payer rejections. Utilizes knowledge of the revenue cycle and patient accounts to ensure claims are submitted in a timely manner. Has regular contact with internal and external customers and does require regular outreach to payers for additional clarification related to claim status. Performs claim research and analysis to resolve claim edits daily related to responses from the payer rejection reports. Uses RealMed, Availity and Payer Web Portals with respect to claim errors, provider enrollment, patient eligibility and claims status utilizing proper customer service protocol. Ensures compliance with HIPAA protocol. Ensures claims are processed and confirmed electronically as well as drop claims to paper when needed. Assess accounts to determine the next appropriate course of action in line with company policies and protocols. Update patient insurance and demographic information.

Skills & Expertise

AccountingAnalyticsClaims ManagementClaims ReviewCompliance ConsultingCourse MaterialCustomer ServiceData ManagementEdiElectronicsGovernment IndustryInsurance ConsultingPatient EducationResearchSystems EngineeringWeb Development

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