EDI Representative at UW Health Northern Illinois – Rockford, Illinois

POSITION SUMMARY:

Under the general direction of the Claims, Provider Enrollment and Scanning Supervisor, the EDI Representative is responsible for the daily transmission and processing of Electronic Data Interchange (EDI) 837- Health Care Claims, 835- Health Care Claim Payment/Advice and 277CA- Claim Acknowledgment. The EDI Representative conducts research and analysis to resolve rejected claims and remittance processing errors.

This position represents UW Health and the Revenue Cycle team by adhering and upholding the UW Health Mission, Vision, and Values, and UW Health Service Performance Standards in providing the highest quality service. They will support their co-workers, engage in positive interactions, and provide helpful assistance in anticipating and responding to the needs of our customers.

EDUCATION/TRAINING:

High School Diploma or equivalent.

Associate’s Degree in Business, Finance, Health Information Management, or related field preferred.

LICENSURE/CERTIFICATION:

N/A

EXPERIENCE/SKILLS/ABILITIES:

• One (1) Year of experience in an insurance, finance, medical office, or customer service related field.
• Revenue Cycle (healthcare business, financial or insurance) experience.
• Epic experience.
• Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms (UB, 1500).
• Ability to make good judgments in demanding situations
• Ability to react to frequent changes in duties and volume of work
• Effective communication skills
• Ability to listen empathetically
• Ability to logically and accurately organize details
• Ability to manage multiple tasks with ease and efficiency
• Self-starter with a willingness to try new ideas
• Ability to work independently and be result oriented
• Positive, can-do attitude coupled with a sense of urgency
• Effective interpersonal skills, including the ability to promote teamwork
• Strong problem-solving skills
• Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders
• Ability to use various computer applications including EPIC
• Excellent PC operating skills (keyboard, mouse) and use of MS Office
• Broad knowledge of health care business office practices and principles
• Basic math skills and knowledge of general accounting principles
• Maintains confidentiality of sensitive information
• Knowledge of Business Office policies and procedures
• Knowledge of local, state and federal healthcare regulations