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EDI Claims Specialist Relevant Educational Qualifications Job

3 months ago Other categories Paradise   431 views
Job Details

Why not work somewhere better? The road to better starts with a single step. Join us on our relentless quest to improve the lives of those who practice medicine and those they care for. Our goal? Healthier patients, happier providers and happier employees. Please visit our website at: www.nextgen.com.

Work directly with clients and payers to ensure that enrollment is completed for successful electronic claims submission.

Job Responsibilities

  • Implementing New and Existing Clients with EDI Transactions
  • Supporting New and Existing Cases for Providers
  • Enrolling New Providers for EDI transactions
  • Manage new and existing Payer Trading Partner connections
  • Support the processing, troubleshooting and management of EDI X12 transactions
  • such as 270/271/835/837/276/277
  • Perform daily manual EDI processes, which cannot be automated
  • Multitask to own client communications while working through any operations
  • related items.
  • Processing claim files through the EDI utilities
  • Contacting Payers and Trading Partners for Escalations
  • Maintain and update related documentation of policy and procedure
  • Pull data via SQL for reporting as needed
  • Maintain a close relationship with VIP clients
  • Work closely with EDI Operations, EDI Development, and PM Support
  • Report and participate in bug related issues with EDI Development through Jira

Required Qualifications

  • 2 plus years of Customer Service experience.
  • Effective written and verbal communication skills.
  • Demonstrate problem solving and researching skills.
  • Strong organizational and interpersonal skills.
  • Experience with Microsoft Excel (document creation, editing, sorting, saving, and storing)
  • Experience with Microsoft Word (document creation, editing, sorting, saving, and storing)
  • Experience with Microsoft Outlook (email organization and calendar scheduling)
  • Proficient with PC's and in Windows based environments.

Preferred Qualifications

  • Provider enrollment experience

NextGen Healthcare believes in strength through diversity. We are an equal opportunity workplace and an affirmative action employer supporting Diversity, Disabled, and Protected Veterans. Qualified applicants are considered for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, gender identity, disability or veteran status.

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Because NextGen Healthcare believes in providing a safe work environment, we conduct background checks as part of our hiring processes.

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Company Description
Who We Are
We’re a leading healthcare solutions provider on a relentless quest to improve the lives of those who practice medicine and their patients.
We Believe A Healthcare Practice Should Be About Helping Patients
Why not work somewhere better? The road to better starts with a single step. Join us on our relentless quest to improve the lives of those who practice medicine and those they care for. Our goal? Healthier patients, happier providers, and happier employees.
We provide tailored solutions to fit the needs of ambulatory and specialty practices, as they strive to reach the quadruple aim while navigating the journey of value-based care.