Healthcare EDI Analyst
Hanger, Inc. 17 reviews - Austin, TX

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"Empowering Human Potential” is more than a tagline; it’s our mantra for all associates that motivates and reminds us of the essential role we play in the lives of our patients and customers. Whether directly or indirectly, every individual across every business unit and department at Hanger is helping to improve the lives of our patients and customers. One by one, we listen to challenges, collaborate with partners, identify solutions, overcome obstacles, lead through innovation, and apply our expertise to help move lives forward.

We know that the “possible” lives inside each of us, waiting to be unleashed. At every touch point across all of our business, we are keeping lives in motion, breaking down barriers, taking dreams further. As one united Hanger, we are achieving more of our own potential so that we can help patients do the same. Together we are working with one idea in mind: Empowering Human Potential. A job with Hanger places you on a path leading well beyond ordinary career opportunities.

We have an opening for an EDI Analyst in Hanger’s burgeoning Revenue Cycle Management (RCM) department. This Analyst will work on a team to support and facilitate the Enterprise Practice Management (PM) system and the enterprise rollout 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. This is a newly-created role within Hanger’s visionary Revenue Cycle Management (RCM) group.

This is an opportunity to join an effectual team in an ever-changing environment. As such, there is a consistent focus on optimizing requirements and leading its adoption into best practice. Forging partnerships with peers, key stakeholders and leaders of other business units in the organization through the use of your strong communication and analytical skills will be paramount.

Responsibilities:
  • 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 disseminate 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
  • Resolve non-standard issues that cannot be resolved by the EDI vendors

Qualifications:
  • 5+ years healthcare EDI lifecycle (e.g. claims, payments, benefits, patient payments ) experience in a large healthcare production environment
  • Ability to write basic SQL queries to extract data.
  • Demonstrated experience working with Clearinghouses and Payer claims Portals
  • Familiarity with EDI (X12)
  • 2+ years’ experience developing Healthcare EDI translation maps
  • Familiar with ICD-10 and HIPAA 5010 standards
  • Demonstrated experience onboarding 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
  • Demonstrated experience within the areas of 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 be able to function independently, or as a team member, and have superior communication and interpersonal skills.
  • Strong PC skills with a working knowledge Microsoft Office suite, especially Excel

Preferred Experience
  • Experience with EHR (Electronic Healthcare Records)/EMR (Electronic Medical Records), NextGen preferred
  • Knowledge of federal and state DME regulations and familiarity with commercial payer rules and regulations
  • Healthcare systems (Revenue Cycle Management, Practice Management, Outcomes Assessment, Patient Collections)
  • Work Experience within a Medical Practice, Central Billing Office, Hospital System, or Payer
  • B.S. or B.A. in business or information systems; professional certification in healthcare EDI preferred. Relevant experience with non-analytical degree or equivalent professional training may be substituted.

About this company
17 reviews
The Premier Provider of Orthotic and Prosthetic Solutions​ Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P)...