EDI Manager

Full Time
Remote
Posted 2 weeks ago

Job Description:

The EDI Manager functions as a leader within the cloud team, providing direction and oversight of the Billing Administration team. The Manager ensures that all support and maintenance of the Revenue Cycle Management (RCM) Accounts Receivable Billing System is carried out in a timely fashion. Manages Billing Administration subordinates to ensure all billing-related protocols are followed in the creation, transmission and troubleshooting of all electronic claim submission files to payers for timely payment.

Responsibilities:

  • Manage own time and subordinates work assignments effectively.
  • Set goals jointly with subordinates; clearly communicate goals and objectives; monitor them regularly through counsel and documentation.
  • Delegate appropriately to subordinates; communicate clearly and thoroughly expectations regarding all delegated work.
  • Monitor and manage employee performance within department, (e.g., enforcement of standard operating procedures, measuring, monitoring and providing feedback regarding productivity and quality)
  • Prepare management reports communicating, project status, critical issues and potential pitfalls.
  • Ensure that sufficient monitoring of staff work occurs and that “refresher” training is available to those who require it.
  • HIPAA, Sarbanes-Oxley and other critical governmental regulations.
  • Work well with other leaders to communicate and share resources on critical projects. Seek opportunities to help others’ projects by sharing and reallocating team members’ priorities and assignments.
  • Develop and sustain excellent working relationships with client professionals (e.g., Operations, Business Development, IT and Finance), as well as with the Company’s clients, payers, consultants, banks and financial intermediaries and government agencies.
  • Develop and execute on multiple project plans in regards to new client business implementations, Government EDI mandates (ICD-10, 5010, OB10, etc.), and special other special projects.
  • Manage the file maintenance tables process and ensure proper set up for smooth billing processes, (e.g., charge/fee schedules, collection plans, contracts, divisions, insurances, lines of business and other business rules).
  • Maintain current expertise with all revenue system-related tools, (e.g., clearinghouse software, eligibility databases and internally developed Access, Monarch or similar report models).
  • Manage the daily Electronic Claim Transfer (ECT) transmissions; ensure the creation of acknowledgement and rejection reports and ensure that system related errors associated with submissions are corrected.
  • Ensure the proper set up and assignment of security levels for all users into the Accounts Receivable Billing System.
  • Ensure the configuration and set up of external network equipment and printers to be used with Accounts Receivable Billing System.
  • Administer Bank lockbox and reporting systems.

Qualifications:

  • High School Diploma.
  • Minimum 3 years experience in a healthcare billing environment.
  • Thorough knowledge of Electronic Data Interchange (270/271, 276/277, 837, 835, 810, and 999 ANSI program transactions.)
  • Advanced knowledge of Microsoft access, ODBC connections, SQL, and Visual Basic scripting.
  • Advanced knowledge in EDI and provider enrollment.
  • Up to 25% travel post-Covid.

Benefits

Integra Connect, LLC provides a comprehensive benefits plan.

  • Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
  • Paid Time Off
  • 401k with employer match
  • Paid Holidays and Floating Holiday

Equal Opportunity Employer

Job Features

Job CategoryBilling Administration

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