EDI Billing and Payment Specialist

Location: Westborough, MA - Corporate Home Office. Fully remote

Schedule: Monday-Friday. 8:00am-4:30pm

Pay rate: $27.00-$29.00/hour

Benefits:

• Health, dental, vision insurance/additional voluntary insurances
• Company-paid life insurance/employee assistance programs
• Generous paid time off accrual
• Tuition reimbursement/loan repayment options
• 401k with company match up to 7%!
• Discounts on wide array of services/entertainment nationwide

The EDI Billing and Payment Specialist is responsible for:

• Ensuring accurate billing and collections of claims
• Concentrate primarily on building a strong and productive relationship with individual insurers in an effort to process denials and appeals in a timely fashion while reducing number of days in A/R
• Identifying and analyzing insurance rejections
• Determining services to be billed to self-pay
• Maintaining appropriate interaction with insurance companies, clients and other Spectrum departments
• Identifying insurance company errors for resubmission
• Knowledge of insurance regulations, benefits and deadlines
• Posting payer payments via 835s and manual posting PRN for both NERC and Spectrum.
• Ensuring all charges have been billed via auditing and tracking of unbilled charges.
• Confirming receipt of billed claims and modifies and rebills any rejections or denials.
• Backup for EDI Administrator.
• Reporting insurance trends to Supervisor

Qualifications:

• High School Diploma, GED or equivalent required
• Previous medical billing experience required
• Strong knowledge of CPT, ICD-9 and HCPC coding preferred
• Denial analysis experience
• Strong phone skills required
• Must have ability to multi-task and organize work and priorities
• Must be able to function as part of a team as well as independently
• Excel spreadsheet experience a plus