Remote Medical processing EDI Medical Claims, Downers Grove, IL
During this 6-month+ contract position you will be responsible for the accurate and timely submission and reconciliation of electronic files related to claims and patient statements. Makes corrections to EPIC Provider and Payor master files as directed. This is a temporary full-time position working Monday-Friday from (8:00am to 4:30pm). Training will be onsite located in Downers Grove, IL for part or all of the first 3 weeks. Once training is successfully completed you will have the option to work 100% remote from home
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Processes EDI claim files and transmissions with a 24-hour turnaround.
- Compiles & transmits claim & patient statement files in accordance w/est. schedule.
- Reports compilation and transmittal problems to EDI Manager.
- Maintains timely and accurate reconciliation of compilation and transmittal process of payor acceptance report using established timeframes and protocols.
- Monitor Masterfile issues and work with DMG IT for updated.
- Resolve claim errors rejections in Epic and Vendor system correct issues and resend information within established time frame.
- Analyze claim error reports, corrects error and resends information within established timeframes.
- Identify if new payor or plan is needed research and work with DMG IT to update Payor list in master files follow the established process.
- Participating in system testing related to Epic upgrades and enhancements across operations.
- Monitor CLIA issues and work with payors (Medicare & HFS), site and lab.
- Work as liaison between patient account and registration in regards to insurance address or claims issues.
- Understands coverage and registration guidelines as related to EDI claim submission and reconciliation process.
- Resolves patient, payor and other department staff inquiries according to established PFS protocols.
Education and Experience
- Experience working in Passport/ClaimSource is preferable.
- Experience working in Epic & Proficient in MS Word and Excel.
- Familiarity using FTP client.
- Effective in communicating verbally and in writing with other staff and departments related to electronic claim files and patient statements
- Schedules and prioritizes for self. Establishes strategies to accomplish specific results and produces desired results.
If you or anyone you know is interested, qualified and immediately available please send an updated resume to us for immediate review and consideration.
Medical Claims Processor / Representative