EDI Analyst III

US
Job ID
2017-12969
# Positions
1
Posted Date
2 months ago(12/1/2017 11:08 AM)

Why Us?

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. Built on the legacy of James Edward Hanger, the first amputee of the American Civil War, Hanger is steeped in 150 years of clinical excellence and innovation with a vision to be the partner of choice for products and services that enhance human physical capability. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

 

Hanger, Inc. is an equal opportunity employer - female/minority/disability/vet.

Could This Be For You?

Hanger, Inc. (HGR), a leader in the health-care field of Orthotics and Prosthetics has an opening for an Analyst to support their Enterprise Practice Management (PM) system and the enterprise roll-out of a Revenue Cycle Management (RCM) solution. This is a professional position with primary responsibilities for the planning, coordination, implementation, and ongoing support associated with the RCM solution.

Your Impact

  • Responsible for investigating and introducing industry best practices into Hanger RCM process.
  • Work with Operations, IT, EDI vendor and trading partners as required to increase the existing number/percentage of electronic claims and payments
  • Work with IT and Practice Management system vendor to maintain an electronic benefits verification system
  • Coordinate with EDI vendor on the testing and implementation of EDI transactions with new and existing trading partners.
  • Work with Operations to identify and implement process improvement initiatives that will streamline billing and collections.
  • Work with trading partners as required to understand, document, and implement their EDI requirements.
  • Develop reporting requirements for managing EDI Inventory, Turn-around-time and process controls.
  • Interface with Operations,  IT, and EDI vendor regarding EDI support-related issues
  • Assist in gathering data focused on the successful prioritization and implementation of new processes
  • Interface with senior/middle management and internal business units to ensure that the RCM program achieves the organization’s strategic goals and business needs
  • Provide guidance on health care trends and effective billing processes to support the department’s EDI personnel
  • Define and implement new or improved work processes to increase quality and efficiency
  • Provide timely reporting to management regarding production issues and trends
  • Performs other duties or special projects as assigned
  • Ability to complete multiple simultaneous projects in a timely manner

Minimum Qualifications

  • B.S. or B.A. in business or information systems or High School Diploma or Equivalent with 5+ years health-care EDI life-cycle (e.g. claims, payments, benefits, patient payments ) experience in a large health-care production environment.
  • Professional certification in health-care EDI preferred. 

Additional Success Factors

 

  • Demonstrated experience working with Clearinghouses and  Payer claims Portals.
  • Familiarity with EDI (X12).
  • Familiar with ICD-10 and HIPAA 5010 standards.
  • Demonstrated experience on-boarding new payers for electronic claims & electronic payment processing.
  • Demonstrated ability to independently research, analyze, and troubleshoot complex EDI-related issues based on a thorough understanding of payer claim cycles and rejection terminology.
  • Knowledge of federal and state DME regulations and familiarity with commercial payer rules and regulations.
  • Demonstrated experience within the  full revenue cycle with an understanding of all aspects including, but not limited to, Electronic enrollment, claim submission, payer reporting, payment receipt, deposit tracking, etc.
  • Demonstrated ability to extract, manipulate, and act upon data in an analytical fashion.
  • Must organize/prioritize work, manage multiple tasks and projects and function effectively as a small-team member.
  • Must be able to function independently, or as a team member, and have superior communication and interpersonal skills.
  • Keep the patient at the center of everything that you do, building lifelong trust.
  • Foster open collaboration and constructive dialogue with everyone around you.
  • Continuously innovate new solutions, influencing and responding to change.
  • Focus on superior outcomes, and calibrate work processes for outstanding results.
  • Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.

Preferred Experience

  • Experience using, and configuring NextGen EPM/EHR.
  • Health-care systems (Revenue Cycle Management, Practice Management, Outcomes Assessment, Patient Collections).
  • Work Experience within a Medical Practice, Central Billing Office, Hospital System, or Payer.
  • Experience with MS SQL to extract data via queries.
  • Strong PC skills with a working knowledge Microsoft Office suite, with strong skills in Excel, Word, PowerPoint, Visio and Project.

Our Investment in You

  • Competitive salary.
  • Competitive health and insurance benefits.
  • Annual target bonus or commission.
  • Paid vacation and sick time.
  • Frequent company update talks with our leadership team.

Hanger, Inc. is committed to providing equal employment opportunity in all aspects of the employer-employee relationship. All conditions and privileges of employment are administered to all employees without discrimination or harassment because of race, religious creed, color, age, sex, sexual orientation, gender identity, national origin, religion, marital status, medical condition, physical or mental disability, military service, pregnancy, childbirth and related medical conditions, special disabled veteran status, or any other classification protected by federal, state, and local laws and ordinances. The Company will comply fully with all applicable state or local fair employment laws that forbid discrimination or harassment on the basis of other protected characteristics. Retaliation against any employee for filing or supporting a complaint of discrimination or harassment is prohibited.​​

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