Henrico, Virginia
Electronic Data Interchange Claims Filing Specialist Job Opening in Henrico, Virginia - Electronic Data Interchange Claims Filing Specialist
Job Summary ? The Electronic Data Interchange (EDI) Claims Filing Specialist is responsible for ensuring claims are successfully and accurately submitted to payers electronically or via paper, while ensuring all required and requested documentation is provided.
* Review and prepare claims in compliance with departmental policies and procedures in order to file with payers either manually or electronically
* Accurately correct billing and clearinghouse errors in order to 837 and 835 files to payers
* Appropriately research and/or forward any payer filing requirements needing additional information to accurately resolve, including updating the filing method
* Responsible for working daily reconciliations to ensure all claims are accounted for between the billing system, work queue system, and clearinghouse
* Review correspondence received and perform appropriate action to resolve
* Meet and maintain established departmental performance metrics for production and quality
* Maintain working knowledge of workflow, systems, and tools used in the department
* Other duties as assigned
Knowledge, Skills, and Abilities * Communication - communicates clearly and concisely, verbally and in writing, utilizing proper punctuation and correct spelling
* Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
* Interpersonal skills - able to work effectively with other employees, patients, and external parties * PC skills - demonstrates proficiency in Microsoft Office applications and others as required
* Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures, and systems
* Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes; able to work quickly and accurately in a fast-paced environment while managing multiple demands; able to work both independently and collaboratively as a team player; demonstrates adaptability, analytical and problem solving skills, and attention to detail; and able to perform basic mathematical calculations, balance and reconcile figures, and transcribe accurately
Education High school diploma or GED required
Required Experience Minimum two years related healthcare experience in medical claims billing, both paper and electronic, preferred.
Physical Demands / Working Conditions? Requires prolonged sitting/standing, some bending, stooping, walking and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports or other information. Requires lifting papers/boxes and pushing/pulling up to 25 pounds occasionally. Work is performed in an office environment or hospital setting. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.
No agencies, please
Job Type: Full-time
Required education:
High school or equivalent
Required experience:
EDI healthcare: 2 years
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