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Medical Biller and EDI Specialist

Medequip Inc.
Aliso Viejo, CA Full Time
POSTED ON 12/28/2024 CLOSED ON 1/10/2025

What are the responsibilities and job description for the Medical Biller and EDI Specialist position at Medequip Inc.?

Job Overview

Are you passionate about the healthcare industry and eager to make a difference behind the scenes? We are seeking a dynamic Medical Biller and EDI Specialist who is passionate about leveraging technology to improve patient care and optimize revenue cycles. Come join a growing company that has been in business for over 32 years. Our team is dedicated to enhancing the healthcare experience through precision, efficiency, and innovation. As a key player in our organization, you'll help streamline the billing process and ensure our Electronic Data Interchange (EDI) systems run smoothly.

As a Medical Biller and EDI Specialist, you will play a crucial role in our revenue cycle, ensuring timely and accurate submission of medical claims and managing electronic data exchanges.

Duties

  • Accurate Billing: Process and submit claims to insurance companies, ensuring compliance with healthcare laws and regulations.
  • EDI Management: Manage EDI transactions, troubleshoot and resolve transmission issues to guarantee seamless data exchange.
  • Claim Tracking: Monitor claim status, address denials, re-submit claims, and follow up with insurance carriers to ensure timely payments.
  • Data Validation: Ensure that patient records and billing data are accurate and up-to-date for smooth claims processing.
  • Compliance Champion: Stay up to date with coding, billing regulations, and payer requirements to ensure compliance and optimize revenue.
  • Collaboration: Work closely with our internal teams, payers, and clients to resolve billing issues and streamline processes.
  • Problem Solver: Proactively identify, investigate, and solve discrepancies in billing and EDI transmissions, ensuring a seamless workflow.
  • Educate and Train: Provide guidance and training to team members on billing procedures and EDI best practices.

Qualifications:

  • Experience: 1 years of experience in medical billing, coding, and/or EDI operations.
  • Tech-Savvy: Proficiency with EDI systems and billing software (Medisoft, Change Healthcare).
  • Detail-Oriented: Ability to maintain high accuracy and efficiency, even in a fast-paced environment.
  • Problem-Solver: A creative and resourceful thinker who can troubleshoot technical issues and overcome billing challenges.
  • Team Player: Strong communication skills with the ability to collaborate across teams.
  • Knowledgeable: In-depth understanding of CPT, ICD-10, and HCPCS coding, as well as insurance claims procedures and guidelines.
  • Compliance-Minded: Thorough knowledge of healthcare regulations (HIPAA) and billing standards.

Job Type: Full-time

Pay: $22.00 - $25.00 per hour

Benefits:

  • 401(k) matching
  • Flexible schedule
  • Life insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Work Location: In person

Salary : $22 - $25

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