EDI Enrollment Rep-550800

GuideWell Source • Remote, OH

13h • Remote

About The Position

Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.

Requirements

• High School Diploma or GED
• 1 year of experience working on a PC in a Microsoft Windows or similar environment
• Data entry experience
• Demonstrated oral, written and interpersonal skills
• Demonstrated organizational skills
• Demonstrated problem solving and research skills
• The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive.
• If you are selected for this position, you must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing documentation must be cleared prior to hire. Most positions are subject to additional Identity Proofing, Fingerprinting and additional Background Investigation screening conducted by the Federal Government to be granted Enterprise User Administration (EUA) system logical access after you begin your employment. Your continued employment is contingent upon the outcome of the complete additional screening criteria required for the position which must find that you meet the applicable government customer's requirements (e.g., suitable for access to CMS information and information systems), as well as any additional investigation which may be required throughout your employment. If you are found not suitable, your employment may be subject to corrective action, up to and including immediate termination of employment.
• You must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents. Note: Employment Authorization Cards (EAD) are not a substitute for Visas or U.S. Permanent Resident Cards.

Nice To Haves

• Demonstrated knowledge of Medicare EDI control logic, the telecommunications platform, types of electronic billing formats, and connection protocol concepts.
• Demonstrated knowledge of Medicare EDI controls and security processes.
• Demonstrated understanding of all possible EDI billing arrangements and systems structures.

Responsibilities

• Process EDI enrollment forms and faxes accurately and timely for all new and existing electronic billers: (40%) Log, validate and process EDI enrollment forms for electronic billing from providers, billing services, clearinghouses, and vendors. Ensure accuracy and completeness in accordance with Medicare and company policy and procedures. This requires accessing and reviewing the EDI Database and the Medicare claims processing systems to determine relevant profile information, establishing cases in the appropriate tracking systems, determining the need for EDI testing, and verifying Medicare authorization to bill electronically.
• Enroll users in the Medicare-offered free billing software.
• Enroll users for Electronic Remittance Advice (ERA) and other value- added EDI products and services.
• Enroll organizations into the Portals, process User ID role requests.
• Maintain the EDI Submitter, EDI Vendor, and Tracking Databases: (40%) Update the databases accurately to ensure all customer data is accurate and detailed for integrity and statistical reporting purposes.
• Communicate effectively. This position displays effective communication skills while performing the following functions: (10%) Interface with provider offices, vendors, clearinghouses and billing services on EDI issues and give input on EDI enrollment or submitter criteria modifications. Interface with EDI staff regarding the EDI enrollment process.
• Complete EDI support calls concerning the EDI/Portal enrollment processes: (5%) Assists organizations in the enrollment process and provide status on the various enrollment forms submitted by customers. Contact providers, vendors, billing services, or clearinghouses to review errors and explain correction procedures. Log call information into tracking systems for provider notification purposes.
• Perform other duties and assignments in support of the goals and objectives of Novitas Solutions, Inc., and EDI Services, as directed. This includes, but is not limited to, various administration tasks for the department including mail and imaging functions. (5%)
• Performs other duties as the supervisor may, from time to time, deem necessary.

Benefits

• Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
• Short- and long-term disability benefits
• 401(k) plan with company match and immediate vesting
• Free telehealth benefits
• Free gym memberships
• Employee Incentive Plan
• Employee Assistance Program
• Rewards and Recognition Programs
• Paid Time Off and Paid Sick Leave

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED