Electronic Data Interchange Specialist

Job Summary

To ensure compliance and accuracy in billing, the full-time Electronic Data Interchange Specialist will manage claims processing through Electronic Medical Records and Practice Management Software, conduct audits on coding, and stay updated on insurance policies and coding changes while working remotely.

Key responsibilities

• Meet daily, weekly, and monthly production and quality standards
• Follow up on complex insurance denials and unpaid balances, filing appeals as needed
• Conduct random audits for proper coding and report trends to management

Required qualifications

• High School diploma or GED required; CPB, CPC, CPC-A, CCS, or CHONC preferred
• Minimum of two years of experience in medical billing, coding, or insurance collections
• Understanding of insurance billing processes and claim form completion
• Knowledge of medical terminology and coding (CPT, ICD-10-CM, HCPCS)
• Experience in Medical Oncology, Radiology, Radiation, Laboratory, or Pathology preferred