Job Description

JOB DESCRIPTION:

The Electronic Data Interchange (EDI) Claims Filing Specialist is responsible

for ensuring claims are successfully and accurately submitted to payors electronically or via

paper, while ensuring all required and requested documentation is provided. Please note that we are unable to sponsor applicants requiring work authorization or visas for the positions currently available. We kindly request that only candidates who already possess the legal right to work in the United States apply for consideration.

RESPONSIBILITIES:

• Review and prepare claims in compliance with departmental policies and procedures in order to file with payors either manually or electronically
• Accurately correct billing and clearinghouse errors in order to submit claims to payors
• Appropriately research and/or forward any payor 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
• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
• Other duties as assigned

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