Electronic Data Interchange Specialist (Medical Clearing House)
Atlanta, GA | Billing
Position Summary:GoHealth Urgent Care partners with healthcare systems across the country to provide unparalleled experiences for our customers, employees, partners and community. We live our values of innovation, collaboration, diversity/inclusion, courage/integrity and accountability. We believe in promoting from within and the value of each team member. Check us out as we are growing and in need of professionals whose mission and values coincide with GoHealth!
The Electronic Data Interchange (EDI) Specialist is responsible for identifying, resolving and maintaining system edits using EPIC, E-Clinical Works and the market specific clearinghouse. This individual will review and track claim rejections to identify and resolve existing or potential issues that would impact efficient and accurate claims adjudication and/or claim status.
- High School diploma or GED required
- Associates degree in related field preferred
- 2+ years of related experience and/or training required
- Experience working claim edits
- Clearinghouse experience required
- Knowledge of governmental and commercial insurance billing requirements.
- Understanding of the revenue cycle workflow.
- Ability to effectively manage competing priorities, and a sense of urgency.
- Demonstrated ability to work independently, take initiative and be self-motivated.
- Ability to work in fast paced, deadline driven environment.
- Possess excellent organizational and follow up skills, with a strong attention to detail
- 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
- Ability to understand basic medical terminology
- Ability to calculate deductible and co-insurance correctly
- Ability to read and understand carrier Explanation of Benefits
- Epic or eClinicalWorks experience
- Experience with Microsoft Word and Excel
All qualified persons are granted an equal opportunity for employment without regard to race, color, religion, sex, sexual orientation and gender identity or expression, age, national origin, citizenship status, disability, genetic information, medical condition, family care leave status, pregnancy or pregnancy-related condition, otherwise qualified disabled or veteran status. The company will comply with all fair employment laws in each of the jurisdictions where we conduct business.
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GoHealth Urgent Care has outstanding career opportunities in Connecticut, Delaware, 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.