Edi Supervisor

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

OCCUPATIONAL SUMMARY

Oversees all aspects of the Electronic Data Interchange (EDI) Department for all client practices. Reports the status of the department to the Mgr Business Office Services.  Supervises the productivity and quality of work of the EDI specialist staff. Has strong working knowledge of the revenue cycle and coordinates a wide range of administrative duties involved in the resolution of client accounts receivable. Able to proactively identify issues and effectively problem solve as issues arise.  Effectively communicates policies, procedures and processes to internal staff and management.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Oversees the day-to-day EDI processes; reviews processes on a consistent basis to identify opportunities for improvement.
2. Ensures all claims and statements are submitted for all clients via the EDI interface.
3. Manages EDI and remittance enrollment for all clients for all payors.
4. Maintains consistent communication with management regarding key issues impacting the performance of the revenue cycle.
5. Identifies, analyzes and assists in resolving work flow process problems.
6. Understands and analyzes monthly reports and is able to identify areas that are not optimal.
7. Collaborates with other Coordinators, Supervisors, Application Managers, IT and others to continually improve revenue cycle processes.
8. Manages the workload of the EDI staff during periods of various absences, including shifting personnel to areas needing assistance
9. Hires, trains, orients and evaluates performance of staff and any other assigned personnel to assure consistent performance of department specific objectives and policies.
10. Informs and educates staff on a regular basis, ensuring their success.
11. Maintains current knowledge of governmental and commercial insurance compliance mandates that effects his or her direct reporting departments.
12. Oversees the planning of in-service training and continuing education based on the changes within government and insurance regulations (yearly or bi-yearly basis).
13. Administers disciplinary action as needed in accordance with NSH policy.
14. Maintains time and attendance records as set by department guidelines.
15. Exhibits outstanding customer service skills; exudes professionalism and leads by example at all times.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION REQUIRED

• Bachelors Degree with 2 years of supervisory experience in a healthcare billing environment OR 3 years of EDI experience with at least two years of supervisory experience
• Extensive knowledge of claim formats and EDI submission requirements
• Computer skills, including Microsoft Office Suite
• Working knowledge of billing software

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION PREFERRED

• Bachelors degree
• Experience with Centricity software
• Knowledge of billing operations, government regulations and insurance provisions