Posted: Monday, March 13, 2017 1:23 AM
We are looking for a Assistant EDI/MCO Claims Adjudicator will support the day to day operations of EDI, including identifying any technical problems with sending/receiving transactions. Someone who demonstrates human relations and effective communication skills between different departments. If you strive for nothing but excellence, this team is for YOU Location: 3900 South 1190 East, Ste. A150, Salt Lake City, UT 84124 Schedule: M:F; 8:00 am : 5:00 pm Pay: Commensurate with experience Benefits: Valley provides a generous benefits package including health and dental, health savings plans and an Employee Assistance Program. Other important benefits include 401K, life and disability insurance plans, tuition reimbursement, paid time off, flexible spending plans and paid holidays. At Valley Behavioral Health we are an innovative, dedicated team who are inspired by helping others lead fulfilling lives, one person at a time. We seek individuals who are compassionate, empathetic, team focused, seek excellence, are resilient, possess high integrity, and are fun to be with. Valley Behavioral Health is a professional, therapeutic services organization with 800+ team members operating 65+ programs that provide a comprehensive menu of treatment and services for people of all ages who are experiencing severe mental illnesses, substance use disorders and behavior problems. We have a well:trained and caring staff of therapists, psychiatrists, case managers, social workers and medical staff. We are a Utah based company with operations in Salt Lake, Summit, and Tooele Counties. Support the day:to:day operations of EDI, including identifying any technical problems with sending/receiving transactions.Generate 837 claim files using EHR system.Work with EDI transmission system contractor to ensure all 837 claim files sent out to appropriate payers (Medicare, Medicaid FFS, Optum, Salt Lake County and Commercial insurance).Check incoming 999 and 277CA transactions for 837 rejections.Fix rejected 837 files or claims, as needed, and resend when necessary.Submit ASCX12 (HIPAA) transactions to valuator, Claredi Classic, for HIPAA errors.Work with payers and contractors for testing of any HIPAA EDI file transactions and program changes.Work with billing staff and programmers on any updates or corrections to EHR systems or EDI transactions.Represent Valley Behavioral Health on UHIN (Utah Health Information Network) Standards Committee, including subcommittees, and ASC X12N (Accredited Standards Committee X12 : Insurance) as back up to EDI Specialist.Help write and approve all UHIN Standards and Specifications.Participate in meetings and calls to create and approve all National Standards for HIPAA transactions.Keep informed on all Federal and Utah State laws and mandates.Work with staff and payers on new programs or contract set ups, to ensure all services can be billed and paid.Answer questions on EHR system, EDI billing and federal regulations for staff.Work with staff and programmers on MCO adjudication systems (Valley Behavioral Health is the Mental Health Managed Care Organization for Summit and Tooele counties in Utah) for issues and updates.Work with MCO providers to set up EDI transactions and testing.2+ yearsA? experience and/or education in EDI transactions (HIPAA/ASCX12).2+ yearsA? experience and /or education in adjudication of healthcare claims.Ability to monitor Demonstrate human relations and effective communication skills.Excellent computer skills.Follows all organization policies and procedures.Meets required productivity standards, if applicable, and other organizational expectations.
• Location: Salt Lake City
• Post ID: 11350924 saltlakecity