• Associate Clearinghouse Specialist

    Job ID
    2018-23023
    Employment Type
    full-time
    Hours Per Week
    40
    Onsite Work Schedule Details
    M-F 8am-5pm
    Address
    5543 Legacy Drive
    City
    Plano
    State
    TX
  • Overview

    nThrive™ is seeking an Associate Clearinghouse Specialist who is responsible for the day to day support and oversight of payer connectivity for clients. This entry-level position assists in supporting the functions of our clearinghouse operations while focusing on the highest level of client satisfaction through quick and correct resolution or triaging of cases and timely interaction with clients and payors.

    Responsibilities

    • Facilitate enrollment of Electronic Data Interchange (EDI) and Trading Partner Agreement (TPA) forms required to submit claims and retrieve reports on behalf of clients
    • Manage setup and maintenance of payor connections including assignment of Payor Codes, Receiver IDs, and Payor IDs
    • Coodinate and oversee provider enrollments with various payors
    • Assist with claim batching configuration and setup
    • Assist with Payor connectivity testing
    • Acquiring, understanding and following submission and retrieval instructions
    • Working with Clearinghouse production resources to set up connectivity in the production environment
    • Root cause analysis, problem solving and continued follow up on issues to resolution
    • Maintain organized and detailed notes with timely status updates on all issues
    • Ability to reach out and escalate issues when resolution is not being reached
    • Assist with Client implementations
    • Assist with maintaining internal payor library
    • Assist with ANSI 5010 file issues
    • Develop working relationships and communications with external EDI departments
    • Coordinate and provide timely status on issues or projects to all involved teams
    • Adheres to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. Adheres to all applicable laws and regulations and the company's governance/compliance program
    • Becomes knowledgeable of internal control responsibilities through training and instruction

    Qualifications

    • Bachelor’s Degree or equivalent, relevant work experience
    • Demonstrate professional motivation, steadiness and dedication and the ability to develop and maintain successful, long-term, relationships with key industry/client contacts
    • Exceptional oral communication, presentation and writing skills
    • Proficient in Microsoft Office (Word, Excel, PowerPoint and Outlook)
    • Demonstrate organizational, problem solving and analytical skills
    • Past or similar experience in a billing office with consistent communication with the payer
    • Demonstrate ability to work in a team environment that requires quick turnaround and quality output

    Preferred Skills

    • Healthcare industry experience a plus
    • Understanding of hospital revenue cycle preferred
    • CRM or SalesForce experience a plus

    About nThrive

    Be Inspired. Ignite Change. Transform Health Care. 

    From Patient-to-PaymentSM, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.

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