EDI Implementation Analyst II

This is a fully remote position, open to applicants in United States.

📋 Description

• Report to the Manager of Health Plan Implementation Analysts

• Evaluate, analyze, and implement moderately complex to complex EDI solutions in an efficient and timely manner

• Oversee relationships with payers and vendors, both internal and external, to fulfill integration goals

• Develop, manage, and secure consensus on documented deliverables with partners from both internal and external sources

• Facilitate partner awareness of Availity functionality and production challenges

• Manage implementations that involve submitters, partners, vendors, EDI, B2B, web transactions, APIs, and other defined methods

• Oversee client timelines and deliverables, resolve issues, manage file transmissions, response reporting, testing, and delivery of results

• Formulate implementation plans, initiate them with clients, and create necessary execution tickets

• Track multiple implementations utilizing Availity tools and processes

• Evaluate standard and non-standard implementations adhering to HIPAA regulations and Availity standards

• Conduct pre-production functional testing and develop and execute test plans

• Mentor EDI Implementation Analysts to ensure timely project completion and compliance with Availity standards

• Coordinate with Payer/Trading Partner, Vendor and Provider Marketing, Business Development, Business Technology Solutions, Product Management, Finance, and Operations

• Facilitate communication between Availity platforms, including HEW, Patient Access, and RCM

• Provide estimates for implementation work

• Manage workflows and uphold implementation commitments

• Represent Availity in a professional manner to external customers

• Assist Channels Sales, Account Management, and Payer Solutions with technical insights

• Ensure seamless transitions to account management or operational support teams

• Communicate new implementations and related changes with comprehensive specifications

• Monitor customer communications for changes that impact business operations

• Collaborate with technology and development teams to ensure requirements are satisfied

• Develop support documentation and standardize processes for ongoing improvement

• Document implementation requirements, test plans, contact information, and escalation procedures

• Investigate, resolve, and document operational issues

• Support implementation maintenance requests, connectivity modifications, and edit/enrichment enhancements

• Migrate clearinghouse partner configurations and specification documentation

• Configure alternative routes for submitters

• Update and maintain payer routing and lists, including route validation

⛳️ Requirements

• Bachelor’s degree or equivalent work experience

• Over 4 years of relevant experience in a technology (information exchange) and/or healthcare setting

• More than 4 years of experience managing simple to moderately complex implementations while delivering results swiftly, responsibly, and reliably

• Familiarity with the healthcare industry, particularly claims processing systems, provider office operations, and customer service processes within a healthcare organization

• Understanding of HIPAA implementation guidelines for claims and other transactions

• Knowledge of HIPAA-mandated ANSI transaction formats

• Proficient in X12 transactions, specifically 837P, 837I, 835, 270/271, 276/277, 278, CCR/CCD

• Capability to create and execute test plans

• Ability to generate documentation such as training materials and reference guides

• Skill in establishing and maintaining effective working relationships with both internal and external partners

• Exceptional written and verbal communication skills, including robust presentation abilities and the capacity to deliver concise executive summaries

• Ability to juggle multiple priorities in a dynamic environment

• Adaptability and openness to change

• Competence in preparing documented customer requirements

• Experience with Submitters, Vendors, and/or Receivers/Payers is advantageous

• Background in customer service and/or relationship management is beneficial

• Experience in software implementations is a plus

• Sponsorship is not available for this position

• Must be capable of using a camera for all virtual meetings

• Candidates must pass a drug test prior to employment

• Must meet United States employment eligibility verification requirements

🏝️ Benefits

• Competitive salary

• Bonus structure

• HSA company contribution

• Healthcare benefits

• Vision benefits

• Dental benefits

• 401k match program available from day one

• Unlimited PTO for salaried associates plus 9 paid holidays

• Hourly associates begin with 19 days of PTO, along with the same holiday benefits

• Wellness reimbursement of up to $250/year for gym memberships, racing events, weight management programs, and more

• Education reimbursement

• Paid Parental Leave for birth and adoptive parents

• Diversity & Inclusion teams and employee groups

• Continuous learning resources and access to industry/technology experts

• Opportunities for community volunteering and charitable engagement

• Remote-first work environment

• Camera/video capability for virtual meetings