Medical Billing Support Specialist

WHO WE ARE

Encoda is the leading claims and denials software solution that acts as the connective tissue between practice management systems, clearinghouses, and payers. In turn, we give practices greater visibility into their claims data, allowing them to address denials more efficiently – and more profitably. Drawing from 30 years’ experience developing and implementing revenue cycle software solutions, the team at Encoda is dedicated to revolutionizing healthcare reimbursement automation. And by doing so, Encoda is enabling customers to grow their businesses while significantly reducing back-office resources.

Today, Encoda realizes the true intention of healthcare reimbursement by enabling our clients to collect the most amount of money, in the shortest amount of time, as cost effectively as possible. How do we do that? By using our customizable, rules-based solution to bridge the workflow gaps between payers, clearinghouses, and practice management systems – allowing our customers to get every penny possible from the payers.

WHO YOU ARE

We are seeking an exceptional Customer Support Representative (CSR), who will join our mission-driven organization reporting directly to the Manager of Support. This person will be responsible for ensuring customer satisfaction by addressing support inquiries, troubleshooting issues, and maintaining the smooth operation of our SaaS software platform. This role focuses on managing Electronic Data Interchange (EDI) processes, particularly the successful exchange of X12 EDI transactions between customers’ Practice Management Systems (PMS) and clearinghouses.

The ideal candidate will have a solid background in supporting healthcare PMS or billing offices, with significant experience managing claims submissions, electronic payment posting, and file transfers. You will have a keen ability to troubleshoot complex issues while working both independently and within a team environment. If you are passionate about improving healthcare through technology and thrive in a fast-paced, collaborative environment, we would love to hear from you! This role offers an exciting opportunity to make a meaningful impact in healthcare while expanding your support skills in a cutting-edge tech company.

Requirements

A DAY IN THE LIFE

• Troubleshoot and resolve customer inquiries related to our SaaS platform, ensuring satisfaction and maintaining strong relationships with customers
• Proactively identify, diagnose and resolve EDI-related issues with a strong focus on accuracy and efficiency
• Monitor and manage the exchange of EDI files (837,835, 277, 999) to ensure smooth transactions between PMS’ and clearinghouses
• Ensure compliance with HIPAA regulations and other relevant healthcare EDI standards
• Assist with the configuration, setup, and ongoing maintenance of EDI processes and PMS integrations for new and existing customers
• Track customer issues through tickets, prioritize critical items, and escalate issues as necessary
• Provide instruction and guidance to customers and internal team members on EDI and SaaS system processes
• Maintain updated knowledge of payor requirements and ensure successful EDI claims submissions, ERA processing, and EFT file handling
• Continuously improve workflows and processes to meet or exceed service-level agreements (SLA)
• Oversee the testing of new X12 trading partners and ensure a smooth implementation process
• Document issues, resolutions, and steps in ticketing systems to maintain a knowledge base for internal teams and customers
• Collaborate effectively with cross-functional teams and independently manage tasks to resolution

WHAT YOU WILL BRING TO US

• High school diploma or equivalent required; college degree preferred
• 2+ years’ experience working with Practice Management Software, billing systems or similar platforms
• Experience with healthcare EDI formats (837, 835, 999, 277) and Medicare/Medicaid compliance
• Familiarly with PMS’ like AthenaPractice, Greenway, NextGen or Nextech is preferred
• Medical billing experience preferred
• Knowledge of HIPAA regulations and ANSI X12 EDI standards
• Familiarity with payor portals and healthcare claims workflows
• Mountain or Pacific time zone location is preferred (looking to support our customers until 7p EST)

Benefits

WHY WORK WITH US

• The opportunity to be a part of a leading healthcare IT SaaS organization with a strong mission and set of values
• Competitive compensation
•  Comprehensive benefit package, including medical, dental, vision, disability, and life insurance
• Matching 401k plan and FSA options
• Front-loaded Paid Time Off (PTO) and 10 company-observed holidays
• Cohesive and engaging remote work culture allowing a healthy work-life balance

OUR CORE VALUES

At Encoda, we do more than profess our values. We practice them through an agreed-upon and shared set of behaviors that make up our DNA. We are clear about what is important to us, and we take care that our intentions, words, thoughts, and behaviors align with those values.

·       Inclusive: We foster an environment where you can thrive among smart, thoughtful, and humble colleagues.

·       Collaborative: We have the courage to ask for help and actively listen to our customers and each other.

·       Authentic: We approach all situations (internal and external) with positive intent and integrity.

·       Committed: We deliver results with a passion for customer success.