Experienced EDI Coordinator skilled in troubleshooting and resolving errors, performing quality assurance audits and training support staff to enhance processes. Excellent communication, planning and problem-solving skills.
Overview
4
4
years of professional experience
Work History
EDI Analyst
GeoBlue
King of Prussia, PA
10.2021 - Current
Analyze eligibility errors generated by incoming EDI file transfer
Provide appropriate feedback to management and IT to mitigate future, similar errors.
Participate in the implementation strategy for new accounts
Provides necessary and timely support as a liaison between the business and IT. This includes production problem resolution and transaction testing for network or platform changes. Audits, tests and helps resolve ANSI X12N issues for compliance.
Support roll out of current and future EDI platforms by serving as an escalation point for testing and implementation
Set up and renew Group accounts in the various test databases
Claims Analyst
GeoBlue
King of Prussia, PA
10.2019 - 10.2020
Analyzing International claims to identify claimant, type of service and charge for each claim submitted.
Applying customer's policy coverage provisions to billed charges.
Initiate payments to providers and customers.
Extensive research in order to act upon submitted claims and maintain appropriate written records of statements and facts relating to claims.
Analyzing international claims of BCBS customers to identify claimant, type of service and charge for each claim submitted to be further submitted for payment to the BCBS network in adherence to their standards.
Revenue Analyst
Med Risk Inc
King of Prussia, PA
11.2016 - 09.2019
Experience with 835 data transfers, formatting, and identifying errors generated during the data transfer process
Data entry and clerical review
Assisted Clients with resolving issues and problem solving
Accounts Receivable
Employee Training
Education
Bachelor of Science - Political Science
Temple University
Philadelphia, PA
2015
Skills
Experience working with electronic eligibility formats, whether proprietary or standard 834-4010/5010
Strong familiarity with analyzing errors generated during 835 data transfer
Excellent professional communication skills
Skilled with correspondence with brokers, vendors and external clients to settle discrepancies