What are the responsibilities and job description for the EDI Billing and Payment Specialist position at Spectrum Health Systems?
Location: Westborough, MA - Corporate Home Office. Fully remote
Schedule: Monday-Friday. 8:00am-4:30pm
Pay rate: $27.00-$29.00/hour
Benefits:
- Health, dental, vision insurance/additional voluntary insurances
- Company-paid life insurance/employee assistance programs
- Generous paid time off accrual
- Tuition reimbursement/loan repayment options
- 401k with company match up to 7%!
- Discounts on wide array of services/entertainment nationwide
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
Qualifications:
- High School Diploma, GED or equivalent required
- Previous medical billing experience required
- Strong knowledge of CPT, ICD-9 and HCPC coding preferred
- Denial analysis experience
- 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
- Excel spreadsheet experience a plus
Salary : $27 - $30