Senior Technical Specialist

2 days ago


New York, New York, United States EmblemHealth Full time
Job Summary

EmblemHealth is seeking a highly skilled Senior Technical Specialist to join our team. As a key member of our IT department, you will be responsible for providing technical support and expertise in electronic medical claims (EMC) systems and processes.

Key Responsibilities
  • Provide technical support and troubleshooting for EMC systems and processes
  • Collaborate with IT and other departments to resolve EMC-related issues
  • Coordinate with Claims Operations to resolve EDI transmission issues
  • Participate in telemarketing initiatives to promote electronic programs and resolve testing issues
  • Manage and coordinate EDI PHI issues with other departments
  • Monitor the execution of EMC medical, dental, and hospital systems, produce and distribute EMC reports, and perform bi-weekly lab recon process
  • Log, schedule, and process EDI transactions in support of commercial provider claims, laboratories, and Medicare Part B and Part A crossover carriers
Requirements
  • 5 years of experience in claims processing systems and Membership and Provider Files
  • 3 years of EMC experience in a healthcare support environment
  • College, technical training, or equivalent working experience
  • Ability to work independently, meet goals and objectives, and possess superior analytical ability and competent product knowledge of all business lines


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