Electronic Claim (EDI) and Data Team Supervisor - West Jordan - Full-Time

Granger Medical Clinic has an immediate opening for a working supervisor position for our EDI - Electronic Data Interchange, and Data Team at our West Jordan Headquarters location.

The EDI & Data Supervisor reports to the Revenue Cycle Claim Integrity Manager and supervises daily functions and oversight of claim processing including but not limited to; electronic and paper submission of provider claims to our Granger Medical Clinic clearinghouse, working applicable clearinghouse edits, rejections or denied claims to generate and process accurate and clean claim submissions. Upload daily files from insurance companies such as ERAs and 277 files, submit electronic patient statement files, and our Data Team processes.

Location:West Jordan Headquarters office

Knowledge and Skills:

• Oversees and helps support claim needs and functions such as processing and working clearinghouse edits for first pass clean claim submissions.

• Working supervisory position with direct support to the team and departmental needs.

• Monitors timely claim submission, and initiates changes or improvements.

• Also includes implementing new goals, procedures and coordinating office efforts to expedite claim processing leading to payment and resolution of accounts.

• Excellent customer service, communication, multi-tasking, and organizational skills.

• Excellent typing and key-boarding skills

• Ability to read and understand medical Explanation of Benefits (EOBs).

• Supervisory skills including interviewing, employee performance reviews, disciplinary record of conversations.

• Detail oriented while maintaining a high level of efficiency and strong time management skills.

• Coordinates and leads the team members' efforts to support processes between other team members, departments, and outside vendors.

• Demonstrates excellent character and strong leadership qualities with physical presence at HQ.

• Must be a team player and enjoy collaborating with people.

• Utilizes systems, various documents and reports to identify and correct errors accurately and within established deadlines.

• Acts as a resource for sharing knowledge and information within the team.

• The job description is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Essential Functions and Duties:

• Submits electronic and paper claims.

• Works with clearing houses to resolve transmission errors.

• Works payer rejection reports.

• Adds payer EDI IDs, groups classes, submission type.

• Review and correct automated claims with errors for insurance submission.

• Create medical claims, check for errors, process claims and submit claims to insurance or re-route to other departments to address the error.

• Collecting data from various sources that support our clinics.

• Reference multiple sources for accurate and up to date processing guidelines (including Insurance/ provider requirements).

• Responsible for maintaining accurate processing of data input.

• Maintain electronic records and logs.

• Maintain data processing workflows.

• Demonstrate ability to access and navigate Noridian website.

• Identifies trends and issues, verbally communicates the issues, and proposes solutions to the Claim Integrity Manager in writing.

• Responds to written and email correspondence within established timelines.

• Prepares a written summary of departmental issues and concerns for Manager.

Education and Experience:

• Three years plus - experience in a lead or supervisor position.

• Strong analytical, problem solving, and management abilities.

• Advanced skills in Microsoft Office and Excel.

• Excellent verbal and written communication and human relation skills required.

• Applicants must demonstrate the potential ability to perform the essential functions of the job.

• High School Graduate or G.E.D. equivalent.

• 2-3 years Healthcare claims (EDI) submission experience.

• 1-year Billing or Coding experience preferred

Physical Requirements and Working Conditions:

• Sedentary work, requiring lifting to 10lbs

• Repetitive motion associated with operating a computer and other office equipment

• Inside, climate-controlled working conditions

Granger Medical Clinic offers competitive wages and excellent benefits. Benefits include:

• Vision
• Dental
• Medical
• Sick Leave
• Paid Time Off
• Life Insurance
• Paid Maternity Leave
• Tuition Reimbursement
• Short- and Long-Term Disability
• Employee Assistance Program (EAP)
• Health Savings and Flexible Spending Accounts
• 401(k) with a Company Match, Profit Share, and Safe Harbor Contributions

Granger Medical Clinic provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Granger Medical Clinic complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, and transfer, leaves of absence, compensation and training.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regards to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability status, genetic information and testing, Family & Medical Leave, protected veteran status, or any other characteristic protected by law.