Electronic Data Interchange Specialist
Atlanta, Georgia | Billing
(Position at GoHealth Urgent Care)
Position Summary:
GoHealth Urgent Care partners with healthcare systems across the country to provide unparalleled experiences for our customers, employees, partners and community. We live our values of innovation, collaboration, diversity/inclusion, courage/integrity and accountability. We believe in promoting from within and the value of each team member. Check us out as we are growing and in need of professionals whose mission and values coincide with GoHealth!
JOB SUMMARY
The Electronic Data Interchange (EDI) Specialist is responsible for identifying, resolving and maintaining system edits using EPIC, E-Clinical Works and the market specific clearinghouse. This individual will review and track claim rejections to identify and resolve existing or potential issues that would impact efficient and accurate claims adjudication and/or claim status.
JOB REQUIREMENTS
Education
High School diploma or GED required
Associates degree in related field preferred
Work Experience
2+ years of related experience and/or training required
Experience working claim edits
Clearinghouse experience required
Required Licenses/Certifications: None
Additional Knowledge, Skills and Abilities Required
• Knowledge of governmental and commercial insurance billing requirements.
• Understanding of the revenue cycle workflow.
• Ability to effectively manage competing priorities, and a sense of urgency.
• Demonstrated ability to work independently, take initiative and be self-motivated.
• Ability to work in fast paced, deadline driven environment.
• Possess excellent organizational and follow up skills, with a strong attention to detail
Customer service skills:
• Ability to represent the Department in a professional manner when interacting with patients, guests,
physicians and their staff
• Ability to handle service issues professionally
• Ability to follow through with customers
Communication Skills:
• Ability to communicate effectively to patients about their medical conditions and the financial aspects of
their care.
• Ability to communicate effectively to patients, centers, and staff regarding departmental policy
Keyboard skills:
• Ability to type proficiently
Teamwork:
• Ability to function effectively as extension of the Center
• Be flexible and open-minded in thought processes
• Maintain focus under pressure
• Share relevant information with other team members
Medical Terminology & Insurance
• Ability to understand basic medical terminology
• Ability to calculate deductible and co-insurance correctly
• Ability to read and understand carrier Explanation of Benefits
Additional Knowledge, Skills, and Abilities Preferred
Epic or eClinicalWorks experience
Experience with Microsoft Word and Excel
#INDCO
All qualified persons are granted an equal opportunity for employment without regard to race, color, religion, sex, sexual orientation and gender identity or expression, age, national origin, citizenship status, disability, genetic information, medical condition, family care leave status, pregnancy or pregnancy-related condition, otherwise qualified disabled or veteran status. The company will comply with all fair employment laws in each of the jurisdictions where we conduct business.
For applicants in California, please review our California Consumer Privacy Statement here.
About GoHealth Urgent Care
GoHealth Urgent Care has outstanding career opportunities in Atlanta, the Bay Area, Connecticut, Delaware, Maryland, Michigan, Missouri, New York, North Carolina, Northwest Arkansas, Oklahoma City, Portland/Vancouver, Texas and Virginia. And all of these positions have one thing in common: flexibility to practice and support urgent care medicine the way it was meant to be, without the stress and bureaucracy of hierarchical organizations. With reasonable work hours that don’t emotionally exhaust or burn them out, our team can balance and prioritize their professional and personal lives. Remote positions are also available.