EDI Billing Analyst II

Labcorp is a leader in diagnostics, drug development and healthcare innovation. Across every role, we harness data and AI to work smarter, move faster and create breakthrough solutions that improve health outcomes for people. With our global scale and deep expertise, you'll do meaningful work, grow your career and make a real impact. Together, we're improving health and improving lives.

The Billing EDI Analyst II is a subject matter expert and billing EDI liaison who works with payers and vendors to ensure the construction and transmission of claims with accurate billing content to permit successful adjudication

Responsibilities:

List the core tasks and responsibilities associated with the role.

• Leads complex projects and issue resolution efforts
• Trains and mentors Billing EDI Analysts
• Liaison with payers and vendors as well as reimbursement analysts and Payer Solutions members
• Educate colleagues to ensure successful transmission of required billing data
• Conduct detailed data analysis of submissions issues and defects while using multiple sources to identify resolution
• Prompt pursuit and escalation as appropriate of payer/vendor issues with claim submission success
• Identify alternate paths when vendor/payer relationships change or when vendor issues prohibit successful claim adjudication timely
• Determine appropriate test cases required for evidence of successful transmission of billing data; requires understanding of payer/vendor specific business and platforms
• Review 837 files and payer response files (TA1, 999, 277 and proprietary) to validate quality and appropriate outcomes of EDI transmission
• Convey updates to management and business stakeholders on issues and project status
• Maintain payer and vendor confidence in Labcorp and staff
• Support colleagues when there are scheduling conflicts
• Identify problems within established timeframes to determine and communicate impact
• Determine and communicate solutions to roadblocks
• Interact and collaborate with team members at all levels, including senior management
• Ability to handle multiple projects simultaneously
• Will work independently, as well as in a team environment
• Build and cultivate strong working relationships over the phone and through email
• Support internal department projects and functional areas
• Maintain accurate and up to date documents such as logs, reports, spreadsheets
• Develop process/documentation material that is easily understood by end users (SOPs)
• Participate in projects, meetings, and training activities

• Bachelor's degree with 5 years relevant experience

• > 5 years of billing or EDI experience preferred
• Knowledge of 837, 999, TA1, 277 files
• Knowledge of medical billing
• Mentoring/Training experience

• Excellent interpersonal and communication skills, both oral and written skills are essential to communicate with others located throughout a wide geographic area primarily via conference calls and email
• Intermediate to Advanced Microsoft Office skills (Excel, PowerPoint, Word, Access)
• Ability to communicate complex procedures clearly and concisely
• Strong analytical and problem-solving skills to evaluate, recommend and develop processes
• Flexibility and the capacity to manage and adapt to changing priorities quickly
• Strong attention to detail and time management
• Problem-solving and organizational skills
• Excellent customer service with ability to maintain composure and respond thoughtfully, quickly and professionally to unexpected client or vendor questions, concerns and issues