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Billing EDI Analyst
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Mcleansville, NC Mcleansville, North Carolina |
About this job
Job ID 17-82111 Date posted 10/03/2017
Billing EDI Analyst
Job function and/or primary purpose: Analysis, troubleshooting, and testing to facilitate proper electronic remittance posting
Transition payers from sending LabCorp paper EOBs to transmitting HIPAA compliant electronic remittance files
* Analyze requirements for proper system settings and populate related data structures to permit appropriate posting to claims with proper next actions taken systematically
* Document trading partner electronic transmission mechanisms and payer specific permitted values
* Ensure Electronic Commerce has completed setups, can obtain remittance files successfully and map them for processing
* Obtain test files from payer, execute in QA environment, evaluate output in comparison with raw data input, approve for production implementation
* Coordinate with other business areas to ensure related required data setups have been completed prior to going live in production
* Ensure subsequent successful receipt and posting of files in production environment
Ensure the successful completion of multiple daily remit cycles comprised of processing all payer electronic remittance files
* Analyze scheduling and executed production remittance jobs to identify changes needed to improve outcomes
* Analyze issues and engage partners in IT Production Support, Electronic Commerce, IT Applications Development, cross-functional teams of LabCorp stakeholders, and payer technical resources to troubleshoot and resolve issues with schedule completion, job abends, file failures, processing concerns, and files we are unable to retrieve/receive
* Implement technical solutions to enable accurate file processing
* Obtain alternate electronic records to permit semi-automated processing when payer system issues prevent HIPAA compliant remittance file creation
* Iinitiate escalation protocol when issues are of sufficient magnitude or are unable to be resolved in a timely manner
Conduct data analysis and system validation as needed for projects or as required for IT changes to system remittance processes
* Gather information from multiple system sources/tools, analyze findings and provide guidance to business operational areas related to remittance posting
* Evaluate and maintain changes to the payer allocation master data
* Assist with payer required EDI enrollments to ensure payers are able to include electronic remittance advice
* Evaluate payer files to ensure payer system changes produce HIPAA compliant files able to be processed by LabCorp
* Perform quality assurance and user acceptance testing of LabCorp system processing to meet business needs and those related to government mandated changes in remittance file structures and permitted values
* Assist with preparation of user documentation and training for system changes related to remittance processes for all claims submitted by LabCorp
Maintain databases, develop and execute reporting
* Develop graphics and analytic content for tracking, prioritization, and management
* Convey updates to management and business stakeholders on issues and project status
Normally requires a Bachelor's Degree or equivalent w/3-5 years Healthcare Billing EDI directly applicable experience.
Required Skills
* Strong communication, both oral and written is essential to communicate with others located throughout a wide geographic area where the primary mode of communication is conference calls and email.
* Strong knowledge of all aspects of billing and accounts receivable processes.
* Strong analytical and problem solving skills. Ability to evaluate, recommend and develop processes.
* Excellent interpersonal and communication skills needed, including the ability to communicate complex procedures clearly and concisely, both orally and in writing.
* Strong PC and systems skills (billing and laboratory systems) and working experience with major software applications for PCs.
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Billing EDI Analyst
Job function and/or primary purpose: Analysis, troubleshooting, and testing to facilitate proper electronic remittance posting
Transition payers from sending LabCorp paper EOBs to transmitting HIPAA compliant electronic remittance files
* Analyze requirements for proper system settings and populate related data structures to permit appropriate posting to claims with proper next actions taken systematically
* Document trading partner electronic transmission mechanisms and payer specific permitted values
* Ensure Electronic Commerce has completed setups, can obtain remittance files successfully and map them for processing
* Obtain test files from payer, execute in QA environment, evaluate output in comparison with raw data input, approve for production implementation
* Coordinate with other business areas to ensure related required data setups have been completed prior to going live in production
* Ensure subsequent successful receipt and posting of files in production environment
Ensure the successful completion of multiple daily remit cycles comprised of processing all payer electronic remittance files
* Analyze scheduling and executed production remittance jobs to identify changes needed to improve outcomes
* Analyze issues and engage partners in IT Production Support, Electronic Commerce, IT Applications Development, cross-functional teams of LabCorp stakeholders, and payer technical resources to troubleshoot and resolve issues with schedule completion, job abends, file failures, processing concerns, and files we are unable to retrieve/receive
* Implement technical solutions to enable accurate file processing
* Obtain alternate electronic records to permit semi-automated processing when payer system issues prevent HIPAA compliant remittance file creation
* Iinitiate escalation protocol when issues are of sufficient magnitude or are unable to be resolved in a timely manner
Conduct data analysis and system validation as needed for projects or as required for IT changes to system remittance processes
* Gather information from multiple system sources/tools, analyze findings and provide guidance to business operational areas related to remittance posting
* Evaluate and maintain changes to the payer allocation master data
* Assist with payer required EDI enrollments to ensure payers are able to include electronic remittance advice
* Evaluate payer files to ensure payer system changes produce HIPAA compliant files able to be processed by LabCorp
* Perform quality assurance and user acceptance testing of LabCorp system processing to meet business needs and those related to government mandated changes in remittance file structures and permitted values
* Assist with preparation of user documentation and training for system changes related to remittance processes for all claims submitted by LabCorp
Maintain databases, develop and execute reporting
* Develop graphics and analytic content for tracking, prioritization, and management
* Convey updates to management and business stakeholders on issues and project status
Normally requires a Bachelor's Degree or equivalent w/3-5 years Healthcare Billing EDI directly applicable experience.
Required Skills
* Strong communication, both oral and written is essential to communicate with others located throughout a wide geographic area where the primary mode of communication is conference calls and email.
* Strong knowledge of all aspects of billing and accounts receivable processes.
* Strong analytical and problem solving skills. Ability to evaluate, recommend and develop processes.
* Excellent interpersonal and communication skills needed, including the ability to communicate complex procedures clearly and concisely, both orally and in writing.
* Strong PC and systems skills (billing and laboratory systems) and working experience with major software applications for PCs.
Apply Now
Share
Location
Check out where you could be working if you apply.
View Map
Related Jobs
* Accounts Receivable Specialist McLeansville, North Carolina
* Director, PMO - Revenue Cycle Management McLeansville, North Carolina
* BILINGUAL Call Center Customer Service Rep McLeansville, North Carolina
Join Our Talent Community
Email:
Interested In:Search for a category and select one from the list of suggestions. Search for a location and select one from the list of suggestions. Finally, click "Add" to create your job alert.
Category:
Location:
Add +
* Medical Billing, McLeansville, North Carolina, United StatesRemove
* Remove
Confirm Email
Explore More
Labcorp Specialty Labs
LabCorp and its Specialty Testing Group, a fully integrated portfolio of specialty and esoteric testing laboratories.
Learn More
Phlebotomy
An important link between our patients and our laboratory.
Learn More
Cytogenetics
Help contribute to health care decisions nationwide.
Learn More
Application FAQs
What you need to know about applying at LabCorp.
Learn More
Your Privacy Choices