Summary:  The EDI Associate controls and analyzes the electronic data flow that includes receipts from hospitals and office practices, outside vendors, and data files moving through our billing system.

Responsibilities:

• Manage data file transfers uploading to billing system
  
• Follow up with the appropriate party when problems arise and document issues of concern
  
• Prompt follow through with clients and/or insurance company EDI departments if data is missing or invalid
  
• Propose new methods of handling the department workflow more efficiently (automation)
  
• Create system of checks and balances that will prevent catastrophic errors in processing files
  
• Analyze "exceptions" data for trends
  
• Give direct input for setting policies and procedures for the department

Specific Job Duties:

• Data Transfers
  Send and retrieve files for claims, remittances and other misc. data files
  Retrieve and verify files from hospitals and insurance companies
  Move files to and from billing system
  Analyze exceptions and suggest corrections
  Reconcile remittances
  
  
• Manage Flow of Demographic Files
  Analyze missing records
  Work with hospitals to resolve issues
  Support MIS department implementation of new sites

Requirements:

Education/Experience/Competencies

• Computer Science/Information Technology degree/certificate, or 2-4 years relevant experience with data transaction and/or electronic information systems
  
• Proficiency in Windows applications such as Word, Excel, Access
  
• Experience with Modem, FTP and VPN connections extremely helpful
  
• Previous experience with physician billing preferred
  
• Medical terminology helpful