Join LabCorp as a Billing EDI Analyst and you'll be a part of an innovative life sciences company that is deeply integrated in guiding patient care and providing comprehensive clinical laboratory services. With a mission to improve health and improve lives, LabCorp delivers world-class diagnostic solutions and pioneers new diagnostic technologies to improve the delivery of care. As a member of the LabCorp team, you will support a dedicated staff in processing over 2,500,000 patient specimens per week.
Do work that matters. Join LabCorp and be a part of our team bringing laboratory diagnostics to a new level.
Billing EDI Analyst responsibilities:
Job function and/or primary purpose: Analysis, troubleshooting, and testing to facilitate proper electronic remittance posting
Transition payers from sending LabCorp paper EOBs to transmitting HIPAA compliant electronic remittance files
- Electronic Data Interchange standards for the Health Care Claim Payment / Advice (835)
- Analyze requirements for proper system settings and populate related data structures to permit appropriate posting to claims with proper next actions taken systematically
- Document trading partner electronic transmission mechanisms and payer specific permitted values
- Ensure Electronic Commerce has completed setups, can obtain remittance files successfully and map them for processing
- Obtain test files from payer, execute in QA environment, evaluate output in comparison with raw data input, approve for production implementation
- Coordinate with other business areas to ensure related required data setups have been completed prior to going live in production
- Ensure subsequent successful receipt and posting of files in production environment
Ensure the successful completion of multiple daily remit cycles comprised of processing all payer electronic remittance files
- Analyze scheduling and executed production remittance jobs to identify changes needed to improve outcomes
- Analyze issues and engage partners in IT Production Support, Electronic Commerce, IT Applications Development, cross-functional teams of LabCorp stakeholders, and payer technical resources to troubleshoot and resolve issues with schedule completion, job abends, file failures, processing concerns, and files we are unable to retrieve/receive
- Implement technical solutions to enable accurate file processing
- Obtain alternate electronic records to permit semi-automated processing when payer system issues prevent HIPAA compliant remittance file creation
- Iinitiate escalation protocol when issues are of sufficient magnitude or are unable to be resolved in a timely manner
Conduct data analysis and system validation as needed for projects or as required for IT changes to system remittance processes
- Gather information from multiple system sources/tools, analyze findings and provide guidance to business operational areas related to remittance posting
- Evaluate and maintain changes to the payer allocation master data
- Assist with payer required EDI enrollments to ensure payers are able to include electronic remittance advice
- Evaluate payer files to ensure payer system changes produce HIPAA compliant files able to be processed by LabCorp
- Perform quality assurance and user acceptance testing of LabCorp system processing to meet business needs and those related to government mandated changes in remittance file structures and permitted values
- Assist with preparation of user documentation and training for system changes related to remittance processes for all claims submitted by LabCorp
Maintain databases, develop and execute reporting
- Develop graphics and analytic content for tracking, prioritization, and management
- Convey updates to management and business stakeholders on issues and project status
Normally requires a Bachelor's Degree or equivalent w/3-5 years Healthcare Billing EDI directly applicable experience.
- Strong communication, both oral and written is essential to communicate with others located throughout a wide geographic area where the primary mode of communication is conference calls and email.
- Strong knowledge of all aspects of billing and accounts receivable processes.
- Strong analytical and problem solving skills. Ability to evaluate, recommend and develop processes.
- Excellent interpersonal and communication skills needed, including the ability to communicate complex procedures clearly and concisely, both orally and in writing.
- Strong PC and systems skills (billing and laboratory systems) and working experience with major software applications for PCs.
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