EDI SPECIALIST - Clinical Revenue Recovery - Full Time - Day in San Diego, CA at Scripps Corporate Offices

Date Posted: 5/31/2018

Job Snapshot

Job Description

At Scripps Health, you will experience the pride, support, respect that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.
You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.
Come put your analytical mind to use in coding and medical reviews. Keeping the company in compliance brings a sense of satisfaction and helps the company at the same time.
This position supports the Cobius database for denials management program for the Central Business Office. The Cobius database is used to track and trend medical record and audit requests, retractions and appeals for RAC, Noridian (CMS), BFCC-Quality Improvement Organizations, Coding DRG audits and Commercial payers.
Provides support for EDI database analysis, design, and operations. Establishes and maintains communications within organization and with partners. Conducts and manages product evaluations. Provides product installation, configuration, and training. Performs systems maintenance to update records, specifications, and operating procedures of partner systems. Maintains EDI account transaction activities.

Job Requirements

Required Education/Experience/Specialized Skills:
  • Excellent critical and analytical thinking and excellent customer service skills. Exhibit excellent written and verbal communication skills.
  • Understanding of electronic data interface concepts with good organizational and project management skills.
  • Business acumen in functional area.
  • Experience as a Data Steward to track and trend audit requests, payment retractions and repayment (example: Cobius- Audit Manager, 360Fresh,  ECIN, ECIN mobile, Health Connect)
  • Experience with Reporting from a data base
  • Intermediate level in Microsoft Excel & or Access
  • Experience with Government Audit (RAC, CERT, ADRs, ZPIC, Commercial Audits, Medi-Cal Reviews
  • Experience with managing Correspondence
  • Experience with HIPPA and hospital policies for release of medical records to third parties to prevent compliance breaches
Scripps Health is repeatedly named on the Fortune Magazine’s 100 Best Companies to work for, the only San Diego-based company and Becker’s Healthcare Top Hospitals. Scripps Health offers a robust Total Rewards Program designed to compensate and motivate you throughout your career. Scripps Health Total Rewards Program includes a broad range of plans and programs including market competitive pay and performance incentives, health and wellness benefits, financial wellness benefits, work-life resources, learning and development opportunities, and rewards and recognition. Unlock your potential with Scripps Health today.

Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.