EDI Billing Specialist, Hosp jobs in United States
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Cook Children's Health Care System · 1 week ago

EDI Billing Specialist, Hosp

Cook Children's Medical Center is a healthcare organization focused on providing advanced technologies and treatments for children's needs. They are seeking an EDI Billing Specialist responsible for timely and accurate billing of claims and managing electronic claims rejections while serving as the primary link between the business and data-trading partners.

Hospital & Health Care
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Growth Opportunities

Responsibilities

Responsible for timely and accurate billing of all claims for physician and/or hospital services
Monitor, direct, or correct all unbilled and pending claim rejections
Develop, coordinate, implement, and manage electronic claims rejections
Establish contact with trading partners, analyzing the data exchanged with any partners
Observe data records to record any errors and correct any failures
Stage the received data for billing operations use
Work with all levels of the organization to support accurate, proper data exchanges within the organization

Qualification

Hospital billing/codingInsurance plans knowledgeCMS UBEDIManaged Care contractsClearinghouse rejectionsEpic Hospital Billing ResoluteKeyboarding accuracyMedical terminologyEffective communication

Required

High School Diploma or equivalent required
Minimum three years relevant work experience in hospital billing/coding or healthcare business office experience
Must possess an advanced knowledge of various types of insurance plans
Understanding of Managed Care contracts, denials and payor methodology
Must have thorough knowledge of billing invoicing practices such as CMS UB and EDI (Electronic Data Interchange)
Expert with clearinghouse rejections, demographics, and modifiers
Ability to work in fast paced, deadline driven environment
Effective oral and written communication skills
Keyboarding accuracy and math aptitude skills

Preferred

Bachelors preferred
Medical terminology, knowledge of insurance and reimbursement procedures preferred
Prior experience with Epic Hospital Billing Resolute preferred

Company

Cook Children's Health Care System

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Cook Children's Health Care System embraces an inspiring Promise – to improve the health of every child in our region through the prevention and treatment of illness, disease and injury.

Funding

Current Stage
Late Stage

Leadership Team

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Mike Simmons
President & CFO Cook Children's Home Health
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Stephen Kimmel
Chief Financial Officer
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Company data provided by crunchbase