EDI Reconciliation Specialist

Introduction

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a EDI Reconciliation Specialist today with Parallon.

Benefits

Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Come join our team as a EDI Reconciliation Specialist. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!

Job Summary and Qualifications

The Electronic Data Interchange (EDI) Reconciliation Specialist is responsible for applying a fundamental knowledge of healthcare billing practices and procedures related to identifying and performing root cause analysis to resolve claim issues, performing claims review, monitoring and resolving issues. This includes creating, following up, and resolving tracking tickets as well as creating and executing reports, working assigned inventory, and assisting managers or staff as needed.

In this role you will:

• Perform reconciliation between the practice management system, billing system, clearinghouse, and payor in accordance with department policies and procedures.
• Oversee the reconciliation of unbilled inventory.
• Troubleshoot, analyze root cause, identify potential resolution, and escalate to manager for any reconciliation discrepancies.
• Resolve assigned inventory and issues, follow-up on outstanding issues, and escalate as needed.
• Provide coverage as needed to appropriately manage department inventory and to meet team benchmarks and service level.
• Complete special projects assigned by management.
• Communicate appropriately with department manager.
• Maintain working knowledge of workflow, systems, and tools used in the department.
• Support EDI department as needed.

Qualifications:

• Minimum one-year related healthcare experience required, such as enrollment for electronic claims submission, remittance, underpayments, money transfers, professional electronic medical billing through clearinghouse, paper medical billing, insurance follow-up, and medical payment posting.
• Prior experience reading and interpreting Explanation of Benefits (EOB) preferred

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

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"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our EDI Reconciliation Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.