RCM Data Coordinator

Sonic Healthcare USA•Dallas, TX

10d•Onsite

About The Position

We're not just a workplace - we're a Great Place to Work certified employer! Proudly certified as a Great Place to Work, we are dedicated to creating a supportive and inclusive environment. At Sonic Healthcare USA, we emphasize teamwork and innovation. Check out our job openings and advance your career with a company that values its team members!

Requirements

High School Diploma
3-5 years of experience in medical billing, claims processing, and compliance with payer contracts, Medicare/Medicaid, and government contract requirements
Prior experience with EDI transactions and front end billing systems

Responsibilities

Research and properly correct claim rejections/edits submitted to the clearinghouse for claims processing and payment.
Identify trends related to EDI transactional edits to potentially create rule in billing system to eliminate or reduce future edits.
Resolve billing edits related to EDI payer issues as they arise by contacting the EDI department of payers or clearinghouse as needed.
Properly research and/or escalate payer EDI issues as appropriate.
Accurately add/maintain referring/ordering providers and clients within the billing system.
Research and resolve missing or invalid data related to charges and/or claims, such as patient demographics, payer ineligibility, inactive payers, etc.
Research and resolve transactional errors such as mismatch financial class, service date questionable, CCI/MUE, etc.
Properly match credit charges to debit charges in billing system.
Monitor charge activity for potential duplicate billing situations.
Research unbilled charges to ensure filing deadlines are met.
Research returned mail for claims address to correct accordingly and update configurations.
Identify and/or resolve pre-processing system errors and claim edits requiring system configuration changes or functionality updates.
Update/maintain Ordering Provider configuration within billing system is accurate and updated timely.
Assist with creating/updating mapping of data from internal and external sources to ensure billing related data is accurate and consistently maintained.
Special projects and other related duties as assigned