PFS EDI Associate

Primary City/State:

Colorado, Colorado

Department Name:

Rev Cycle Central Supp Svcs

Work Shift:

Day

Job Category:

Revenue Cycle

Primary Location Salary Range:

$27.16 - $34.74 / hour, based on education & experience

In accordance with State Pay Transparency Rules.

A rewarding career that fits your life. As an employer of the future, we are proud to offer our team members many career and lifestyle choices including remote work options. If you’re looking to leverage your abilities – you belong at Banner Health. 

The PFS EDI Associate oversees the daily automated billing and posting job streams within assigned departments; identifies errors and exceptions, trouble-shoots and corrects errors, entailing posting and reconciliation of transactions

This role requires equivalent experience typically obtained through four or more years of work experience in a financial services or patient account management environment with a broad understanding of patient billing and patient accounting systems.

Monday - Friday 8 hour days

This can be a remote position if you live in the following states only: AK, AZ, AR, CA, CO, GA, FL, IA, ID, IN, KS, KY, LA, MD, MI, MO, MN, MS, NH, NM, NY, NC, ND, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WI, WV, WA, & WY 

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

POSITION SUMMARY
This position oversees the daily automated billing and posting job streams within assigned departments; identifies errors and exceptions, trouble-shoots and corrects errors, entailing posting and reconciliation of transactions

CORE FUNCTIONS
1. Monitors daily translation and transmission of electronic billing claims and printing of UB92, UB04, HCFA 1500 and CMS 1500 claim forms, including identifying and correcting errors, and ensuring balancing of all activities by extracting crucial data elements and performing analysis on results.

2. Obtains and prepares and posts daily, weekly and monthly payment and adjustment transactions using the electronic posting program. Identifies errors and exceptions, researches, corrects and posts to appropriate accounts with adequate documentation. Ensures all transactions balance and identify and correct errors.

3. Researches and evaluates third party claims companys' edits and modifications with payer units to validate appropriateness for Banner Health billing processes. Validates compatibility of new or requested edits with existing billing processes and procedures.

4. Researches, implements and tests new lines of electronic billing and posting. Participates in new software setup requiring engagement of other Banner departments, vendor contacts, and internal reviewers.

5. Utilizes multiple systems and/or programs to provide statistical data in support of issues list(s) provided to payers and internal customers/management.

6. Maintains an accurate and low balance in claims billing system and General Ledger holding accounts for irreconcilable transactions. This entails contacting possible recipients, researching payment documentation, reviewing patient accounting system, contacting finance department, reviewing GL transactions, and participating as needed in bank account reconciliations.

7. May provide training to other staff, provide feedback to improve processes, and work on special projects. May function as a project/or process lead within the unit.

8. Works independently under general supervision using specialized knowledge to solve technical problems for systems used in multiple locations. Represents the interests and needs of the company in working with external vendors and support services for information technology products. Internal customers include patient financial services staff, Desktop/Network Support Services, and finance and accounting staff. Acts as member of various enterprise EDI departments; processing an average of $18,000,000 per day.

MINIMUM QUALIFICATIONS

High school diploma or equivalent required. Requires knowledge normally evidenced by advanced education in accounting or information systems.

Equivalent experience typically obtained through four or more years of work experience in a financial services or patient account management environment with a broad understanding of patient billing and patient accounting systems. Position requires expert analytical skills. Applicant must have the ability to test, document and implement new application programs over various hardware platforms. Requires the ability to analyze and effectively recognize system problems. Excellent follow through needed to resolve system application issues within a timely manner. Ability to gather and analyze data elements from automated systems to troubleshoot and resolve data or application errors. Must have the ability to plan and organize large data sets. Must have the ability to interact with Banner’s Information Technology staff and guide them to technical solutions for system issues. Requires knowledge of medical terminology and an understanding of the laws associated with confidentiality, credits and collections. Effective communication skills, both verbal and written, and human relations skills are required.

PREFERRED QUALIFICATIONS

Bachelor’s degree in Accounting, Finance, or Information Technology is preferred.

Additional related education and/or experience preferred.

DATE APPROVED 09/11/2016

Anticipated Closing Window (actual close date may be sooner):

2025-06-13

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

Privacy Policy:

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