Description

Manage and support the electronic exchange of healthcare information and connectivity.

Responsibilities

• Monitor and troubleshoot EDI transactions to resolve errors and communicate connectivity issues to stakeholders.
• Ensure all EDI transactions comply with HIPAA regulations.
• Collaborate with internal teams and external partners to resolve transaction issues and host working sessions with vendors and clients.
• Develop and maintain EDI documentation, including companion guides, smart checklists, and payer lists.
• Optimize product solutions by managing payer-specific edits and identifying process improvement opportunities.

Required Skills

• 5+ years of experience in healthcare eligibility, benefits, and reimbursement (hospital and physician).
• Deep knowledge of X12 healthcare transaction sets, specifically 270/271, 276/277, 278, 837, and 835.
• Proficiency with EDI protocols and standards, including AS2, SFTP, and API.
• Experience using Salesforce and Atlassian Jira for case management and issue documentation.
• Strong ability to gather, analyze, and manipulate healthcare data using Microsoft 365 and Excel.
• Solid understanding of healthcare reimbursement and patient access workflows.
• Experience working within Agile methodologies such as Scrum or Kanban.
• Ability to manage and support EDI integration within healthcare management systems.

Preferred Skills

• Demonstrated SQL query skills and experience.
• Familiarity with EcareNext/PE.

Key Skills

Education

Any Graduate