EDI Billing and Payment Specialist

Spectrum Health Systems•Westborough, MA

1d•$27 - $30•Remote

About The Position

The EDI Billing and Payment Specialist is responsible for: Ensuring accurate billing and collections of claims Concentrate primarily on building a strong and productive relationship with individual insurers in an effort to process denials and appeals in a timely fashion while reducing number of days in A/R Identifying and analyzing insurance rejections Determining services to be billed to self-pay Maintaining appropriate interaction with insurance companies, clients and other Spectrum departments Identifying insurance company errors for resubmission Knowledge of insurance regulations, benefits and deadlines Posting payer payments via 835s and manual posting PRN for both NERC and Spectrum. Ensuring all charges have been billed via auditing and tracking of unbilled charges. Confirming receipt of billed claims and modifies and rebills any rejections or denials. Backup for EDI Administrator. Reporting insurance trends to Supervisor

Requirements

High School Diploma, GED or equivalent required
Previous medical billing experience required
Strong phone skills required
Must have ability to multi-task and organize work and priorities
Must be able to function as part of a team as well as independently

Nice To Haves

Strong knowledge of CPT, ICD-9 and HCPC coding preferred
Denial analysis experience
Excel spreadsheet experience a plus

Responsibilities

Ensuring accurate billing and collections of claims
Concentrate primarily on building a strong and productive relationship with individual insurers in an effort to process denials and appeals in a timely fashion while reducing number of days in A/R
Identifying and analyzing insurance rejections
Determining services to be billed to self-pay
Maintaining appropriate interaction with insurance companies, clients and other Spectrum departments
Identifying insurance company errors for resubmission
Knowledge of insurance regulations, benefits and deadlines
Posting payer payments via 835s and manual posting PRN for both NERC and Spectrum.
Ensuring all charges have been billed via auditing and tracking of unbilled charges.
Confirming receipt of billed claims and modifies and rebills any rejections or denials.
Backup for EDI Administrator.
Reporting insurance trends to Supervisor