Electronic Data Interchange Manager
Atlanta, GA | Billing
Founded in 2013 on the philosophy that people deserve the highest-quality patient experience in a walk-in care environment, GoHealth Urgent Care has grown to more than 125+ state-of-the-art urgent care centers in just a few years and we continue to expand rapidly.
The EDI Manager manages all functions of the organizations claims edits and clearinghouse troubleshooting to maximize cash flow while maintaining and improving internal and external customer relations.
- High School Diploma or GED required
- Bachelor’s degree in Business Administration or related field preferred
- 5 years of Healthcare experience required
- 3 years of progressive management experience required
- 2 years of accounts receivable or clearinghouse experience required
Additional Knowledge, Skills and Abilities Required
- Strong knowledge of the Accounts Receivable process
- Excellent phone, communication, organizational skills, computer skills and mathematical skills
- Ability to maintain patient confidentiality
- Strong attention to detail
- Strong problem-solving skills and ability to make timely decisions
- Strong knowledge of process and understanding of practice management systems
Additional Knowledge, Skills, and Abilities Preferred
- Epic or eClinicalWorks experience
- Experience with Microsoft Excel and Word
- Maintain Daily communication with direct reports and team leads.
- Maintain a high level customer service approach to working with Payment Posting Specialists, payors and centers
- With support of the Director; interview, hire, and review team members
- Implement audits of team’s efficiency and thoroughness when working outstanding AR accounts
- Recommend team for structured quarterly bonus calculation
- Provide training for all staff
- Establish with Director policies for the EDI department
- Track and document department productivity and make changes necessary in order to meet department goals
- Ability to motivate and engage team members
- Work with clearinghouse to troubleshoot any issues
- Oversee the claim edits work queue across all markets
- Provide feedback and training as necessary to the markets
- Update senior management regarding operational trends in regards to front desk workflows
- Complete any clearinghouse enrollments for existing and new markets
- Maintain clearinghouse logins
Required knowledge, skills and ability:
Customer service skills:
- Ability to represent the Department in a professional manner when interacting with patients, guests,
- physicians and their staff
- Ability to handle service issues professionally
- Ability to follow through with customers
- Ability to communicate effectively to patients about their medical conditions and the financial aspects of their care.
- Ability to communicate effectively to patients, centers, and staff regarding departmental policy
- Ability to type proficiently
- Ability to function effectively as extension of the Center
- Be flexible and open-minded in thought processes
- Maintain focus under pressure
- Share relevant information with other team members
Medical Terminology & Insurance
- Ability to understand basic medical terminology
- Ability to calculate deductible and co-insurance correctly
- Ability to read and understand carrier Explanation of Benefits
All other duties as assigned.
Note: this job description is not inclusive of all the duties of the position. You may be asked by leaders to perform other duties. Management reserves the right to revise this position description at any time.
GoHealth provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. We invite military veterans to apply for our positions. In addition to federal law requirements, GoHealth complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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GoHealth Urgent Care has outstanding career opportunities in Connecticut, Missouri, New York City, North Carolina, Northwest Arkansas, Oklahoma City, San Francisco and the Portland-Vancouver area. And all of these positions have one thing in common: flexibility to practice urgent care medicine the way it was meant to be, without the stress and bureaucracy of hierarchical organizations. With reasonable work hours that don’t emotionally exhaust them or burn them out, our team can balance and prioritize their professional and personal lives.
The lifestyle you can lead.
Atlanta is Georgia’s state capital and home to approximately half a million residents. Well known for its arts, theater, galleries and museums, cultural attractions, and institutions of higher education, Atlanta offers many things to do. Visit Georgia Aquarium, the largest public aquarium in the Western Hemisphere. Shop and enjoy great entertainment in Underground Atlanta. See wildlife shows at Zoo Atlanta. Catch a pro football, basketball or baseball game. Foodies will delight in local favorites, such as crab fritters, chicken biscuits, pulled pork sandwiches and salted caramel ice cream. Choose from many welcoming neighborhoods to live in, from downtown and midtown to Chastain Park, and from Buckhead to Cabbagetown, Kirkwood and Morningside. There’s also a good selection of public and private schools and nearby colleges and universities. Public transportation is excellent, and Atlanta is also served by Amtrak and Hartsfield-Jackson Atlanta International Airport.