Job Description

What your impact will be:

• Work on EDI Projects and Enhancements.
• Daily Reconciliation of all EDI claim files.
• Provide daily report of the total claim counts, exceptions, and any variances with explanation.
• Perform change request (CR)/ticket analysis, and escalate issues and risks in a timely manner.
• Work on Billing cases and monitoring patient statements for the clients and take corrective action with other teams.
• Presentation on Billing Modules.
• Documenting for ERA Posting for the Billing Team to streamline the process of resolving cases and also share the same with the Engineering, Technical support Team.
• Performing as a team player and working on projects as per assigned.

What we are looking for:

• 2+ years of experience in US Healthcare Industry
• 2+ years of experience on HIPAA EDI transactions (such as 837 (I/P), 270/271, 276/277, 278, 820, 835, 997, 999)
• Proficient with Microsoft Office software to include: Outlook, Word, Excel.
• Proficient with SQL language (good to have).
• Extensive knowledge of the health care/payer/insurance industry, specifically claims processing systems, Eob Posting, provider office operations, and customer service/Client handling processes in a health care company.
• Well Equipped about Module of Practice Management & Billing Product Front-End Setup and EDI Loops and Segments.
• Thorough Knowledge of EDI Loops and Segments and CMS requirements for UB04, Professional Claims.

What would make you stand out:

• Proficient in EDI Data Analysis and Operating Excel Functions.
• EDI Configuration and Process monitoring.
• Proficient in EDI Data Analysis and Operating Excel Functions.
• Ability to debug issues and to perform well under pressure situation.
• Good Presentation & Public Speaking Skills and proficient in operating MS PowerPoint
• Good in decision making and analytical skills toward troubleshooting, automatization of feature, and making our software more user friendly.