Job Description:
• Manage the EDI (Electronic Data Interchange) trading partners and network of clearinghouses to ensure accurate and timely exchange of information
• Work closely with Vendor Management to improve and maintain trading partner agreements
• Provide Subject Matter Expertise (SME) to all departments regarding eBusiness specific EDI transactions
• Build, sustain and leverage relationships to allow for continuous improvement of the EDI business process
• Responsible for eBusiness EDI requirements that support regulatory, compliance, and business needs
• Provide critical reporting and analysis of functional performance
• Review and analyze the effectiveness and efficiency of existing processes and systems
Requirements:
• Bachelor’s degree or equivalent years of relevant work experience is required
• Minimum of five (5) years of health care operations experience in insurance, managed care, or related industry is required
• Advanced knowledge of healthcare EDI files (837, 277CA, 999, 270/271, 276/277, etc.)
• Advanced computer skills
• Data analysis and trending skills to include query writing
• Working knowledge of managed care and health claims processing
• Must be able to effectively interact with all levels of management within the organization and across multiple organizational layers
Benefits:
• Health insurance
• 401(k) matching
• Flexible working hours
• Paid time off
• Substantial and comprehensive total rewards package
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