Senior Payment & EDI Specialist (Upper Darby, PA)

Join Chimes - and go further to help others go far! Chimes is a not-for-profit organization that assists people with intellectual and behavioral challenges to achieve their fullest potential.Our vast array of services - educational, employment, vocational, residential, habilitative and behavioral health - are delivered through a network of national and international affiliates.

This allows us to take a comprehensive, holistic approach to improving the lives of every person we serve - those who receive and those who reap the benefits of our innovative, responsive solutions.Compensation: $67,000 - $69,000 YearlySchedule: Monday - Friday 8:00am-5:30pm
Location: Upper Darby, PAPRIMARY JOB FUNCTION(S):

Accurately and efficiently post all payments from Explanation of Benefits (EOBs), Electronic Remittance Advice (ERAs), and patient payments to individual patient accounts within the practice management system

Utilize payor portals (e.g., Availity, Change Healthcare, direct payor portals) and state claims systems to verify eligibility, check claim status, retrieve EOBs, and resolve payment discrepancies.

Reconcile daily payment batches with bank deposits and GL entries, identifying and resolving any discrepancies.

Lead the enrollment process for all new and existing payors for Electronic Data Interchange (EDI) for 837 (claims), 835 (remittance advice), and 270/271 (eligibility/benefits) transactions.

Act as a primary contact for payor EDI support, resolving complex enrollment and transmission issues.

Identify opportunities for process improvement and automation within the payment posting and EDI functions.

Develop and deliver training programs for new and existing payment posting and EDI staff, ensuring adherence to best practices and departmental policies.

Reports to the AR Manager or designee any breaches of Agency accounting policies and procedures.

Meets deadlines as required for month-end and year-end processing.

Strong understanding of revenue cycle management within a healthcare setting, specifically behavioral health (outpatient and residential preferred) and IDD.

Assists with and prepares needed documents for audits.

Monitors customer accounts totals for accuracy and collectability.

Communicates immediately with AR Manager or designee issues regarding billing and receivables.

Uses advanced technology for the completion of specified job duties.

Attends work regularly according to the assigned work schedule and in accordance with Agency policy.

Attends and participates in in-service training, staff meetings, and other activities to facilitate professional development.

Works cooperatively with others, including all staff, supervisors, administrators, co-workers, individuals served, community professionals, customers, vendors and the public.

Follows instructions and abides by Agency policies and procedures.

Be a positive role model for individuals served and Agency staff.

Assumes other d...