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EDI Representative

Company: US Physical Therapy and OPR Management
Location: Houston
Posted on: November 22, 2021

Job Description:


U.S. Physical Therapy, Inc. ("USPh"), which was founded in 1990, is the largest publicly-traded, pure-play operator of outpatient physical and occupational therapy clinics, with over 560 clinics in 41 states. The clinics provide pre- and post-operative care for a variety of orthopedic-related disorders and sports-related injuries, rehabilitation of injured workers and preventative care.

We have an immediate need for an individual who wants to join our exciting company as an Enrollment Specialist. This position is based out our Corporate Office on the Westchase area of Houston.


The EDI Rep is our Enrollment Specialist and you will be an expert at ensuring that the electronic data exchanged between systems is accurate to ensure prompt reimbursement from various payors. Previous experience as a senior biller, patient account representative, with an outstanding customer service attitude would be an asset in this position.

Essential Duties and Responsibilities include the following, other duties may be assigned:

Visits payor websites and completes online EFT and ERA enrollment forms accurately and timely, with appropriate signatures
Tracks each enrollment form to completion on Microsoft Excel, following up with payor as necessary
Responds to payor and clinic telephone calls and/or emails in a timely manner
Troubleshoots batches uploaded by clinics and provides timely solutions and feedback
Review and research claim denials, and rejections, communicates to Clinics on any backlogs
Answers the EDI Help Desk phone line, making sure to document, track and monitor support requests to ensure a timely resolution; provides technical support to end users on any issues related to ANSI 837P and 837I billing forms
Identify, research and resolve technical problems related to denied and rejected claims
Reports to management any specific trends or issues
Responds to management special project requests
Provides coverage as needed for other departmental personnel
Supports and maintains information security measures as appropriate to the position, including HIPAA rules and USPh standards of confidentiality

The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.

Education and/or Experience:

High School Diploma or equivalent, required
A minimum of one (1) years' experience in a medical billing and collection environment (i.e. Customer Service Representative with a Payor, Enrollment Specialist, Patient Account Representative, or Biller), required
Experience with ZirMed-- Claims or Waystar Clearinghouse software
Experience with Track-It-- Work Order software or equivalent
Experience with Raintree-- practice management software
Knowledge of ANSI Code Set as it applies to 837P and 837I healthcare billing
Proficiency in Microsoft Office (with a strong working knowledge of Excel) is required

Apply online today to be considered!

Keywords: US Physical Therapy and OPR Management, Houston , EDI Representative, Other , Houston, Texas

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