EDI Specialist

Essential functions:

• Resolve claim rejections. Identify claim errors including but not limited to clerical errors and missing information.

• • Pinpoint clearinghouse rejection trends and evaluate possible solutions to reduce or eliminate future rejections.

• Ensure daily macros submissions are successful. Research and resolve issues with unsubmitted claims then manually submit.

• Identify payors who are not paying electronically and submit applications to receive EFTs and ERAs

• Validate payer mapping in the clearinghouse to guarantee accurate claims submissions
• Submit paper claims in practice management system for remote print
• Resolve locked accounts and provide new credentials for payer websites

Preferred Skills:

• Knowledge of general healthcare A/R and billing procedures and processes.
• Excellent computer skills including Microsoft Word and Excel.
• Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
• Requires strong organization, time management, and verbal and written communication skills.
• Strong attention to detail.

Qualifications:

• Strong English comprehension with the ability to communicate professionally in writing.
• Comfortable working with computers and capable of learning new programs quickly.
• Ability to multitask and master the essential functions required for this position with little to no supervision.
• Bachelor's Degree

Current Openings for EDI Specialist Jobs at PMAX Global