EDI Billing Specialist

Iowa Radiology is seeking a highly skilled and dedicated EDI BiIling Specialist to join our team. Iowa Radiology is a patient-centered practice that promotes a more compassionate approach to medicine. We provide our employees the ability to bring their authentic selves to work every day, providing compassionate care for our patients in a collaborative, supportive work environment.

Essential Responsibilities:

• System Administration: Serve as the system administrator for the billing software, overseeing interfaces and crosswalk creations.
• Third-Party Integration: Manage the implementation and training of all third-party products used in the billing process.
• RCM Projects: Lead and drive revenue cycle management (RCM) projects and implementation efforts to improve efficiency.
• Interface Management: Maintain working knowledge of HL-7 interfaces files and troubleshoot any issues with facility interfaces.
• Insurance Website Management: Manage access to insurance company websites for billing and clinic staff.
• EDI Management: Oversee all EDI connections for claim submissions and payment transactions.
• Insurance Table Maintenance: Responsible for maintaining insurance tables within the clinic’s RIS (Radiology Information System) to ensure accurate and up-to-date billing information.
• Technology Advancements: Keep updated with advances in technology relevant to the billing and revenue cycle process, implementing new tools and systems that can enhance efficiency, security, and accuracy.
• Managing and submitting electronic claims/invoices.
• Coordinating with clearinghouses, vendors, and insurance companies.
• Investigate and correct errors (format issues, missing data, payor rejections, rejected claims, or failed invoices).
• Reconciling payments and maintaining billing records.’
• Ensures billing follows industry regulations (especially healthcare standards like HIPAA).

• Merchant Acquisition: Acquire and set up credit card merchants for processing transactions.
• PCI Compliance: Ensure the organization maintains annual PCI compliance by staying current with credit card rules and regulations.
• Transaction Process Management: Oversee the file transfer process of credit card transactions from the merchant to the billing system.
• Merchant Disputes: Respond to and resolve all merchant complaints or transaction related issues.

• Additional Responsibilities: Performs other duties as assigned to ensure the smooth operation of the billing office and revenue cycle.

• 2-year degree in Business Administration/Management, Healthcare Administration/Finance, or related field or equivalent experience.

• Must be able to read, write, and speak English fluently.
• Minimum of five (5) years of billing and insurance experience.
• Experience with email, internet, and Microsoft Office products.
• In-depth knowledge and experience working with billing electronic systems.
• Knowledge of HL-7 interfaces
• Knowledge of procedure codes, diagnosis, and insurance specifications.
• Ability to communicate effectively with both internal team members and external customers.
• Excellent organizational skills and the ability to multi-task and make quick but accurate decisions.