Deskripsi Pekerjaan
Are you a detail-oriented professional with a passion for healthcare data integrity? Vector Outsourcing Solutions is seeking a dedicated EDI Specialist to join our remote-first team. In this pivotal role, you will be the bridge between technical data streams and seamless healthcare operations, ensuring that claim edits and re-submissions are handled with precision and speed.
You will be instrumental in maintaining the quality of our Electronic Data Interchange (EDI) processes, troubleshooting clearinghouse rejections, and collaborating with cross-functional teams to minimize claim denials. We are looking for an analytical mind who thrives in a fast-paced environment and understands the critical nature of accurate medical billing documentation. If you are tech-savvy, process-driven, and ready to make an impact in the healthcare technology sector from the comfort of your home, we want to hear from you!
Tanggung Jawab
- Monitor and analyze daily EDI edit reports to identify claim errors and rejection trends.
- Execute timely repairs on rejected claims to ensure successful re-submission to payers.
- Act as the primary point of contact for clearinghouse communication and troubleshooting.
- Maintain high levels of accuracy in data entry and medical claim documentation.
- Collaborate with billing departments to resolve recurring claim formatting issues.
- Track and document all claim adjustments and resubmission workflows.
- Adhere to HIPAA compliance and data privacy standards in all handling of PHI.
Kualifikasi
- Minimum 2 years of experience in healthcare revenue cycle management or EDI claims processing.
- In-depth understanding of EDI transaction sets (837/835) and clearinghouse portals.
- Proficiency in medical billing software and strong MS Excel skills.
- Excellent analytical, problem-solving, and time-management abilities.
- Strong verbal and written communication skills for cross-departmental coordination.
- Ability to work independently in a remote environment while meeting strict deadlines.
- Working knowledge of ICD-10, CPT, and HCPCS coding standards.