EDI Implementation Analyst III

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Availity

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2000

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Secondary Market on 2021-07

Healthcare • Consulting • Logistics

Availity is a leading health information network that connects payers, providers, and technology partners in the healthcare industry. By facilitating over 13 billion clinical, administrative, and financial transactions annually, Availity streamlines payer-provider collaboration and enhances patient care through an integrated provider engagement platform. The company's solutions leverage artificial intelligence and interoperability to automate processes such as prior authorizations, revenue cycle management, and payment accuracy, ultimately reducing costs and improving efficiency across the healthcare ecosystem.

📋 Description

• Own complex, high-visibility EDI implementations from a receiver perspective • Apply advanced Availity system knowledge, independent judgment, and cross-functional partnership to analyze, design, implement, and improve scalable solutions • Manage payer, vendor, partner, and cross-functional relationships to meet Program Management objectives • Lead complex, high-impact implementations across submitters, partners, vendors, and receivers/payers for EDI, B2B, web, API, and other transaction methods • Develop implementation plans, initiate customer workstreams, create required tickets, identify risks and dependencies, recommend mitigation strategies • Manage multiple complex implementations, including timelines, dependencies, stakeholder alignment, issue resolution, escalations, and results delivery • Lead pre-production testing with internal and external stakeholders, including test plan execution, defect resolution, and readiness validation • Engage business, technical, internal, and external stakeholders on implementation solutions while representing Availity professionally

🎯 Requirements

• Bachelor’s degree or the equivalent work experience • 6+ years of related experience in a technology, information exchange, EDI, and/or healthcare environment • 6+ years managing moderate to highly complex implementations with independence, accountability, and sound judgment • Knowledge of healthcare operations, including claims processing, provider office workflows, and customer service processes • Understanding of HIPAA implementation guides for claim and other transactions • Knowledge of HIPAA-mandated ANSI transaction formats • Working knowledge of X12 transactions specifically 837P, 837I, 835, 270/271, 276/277, 278 • Ability to develop and guide test plans, evaluate results, and resolve defects or dependencies • Ability to create documentation such as training resources and reference materials • Ability to establish and maintain effective working relationships, supporting internal and external partners • Ability to influence cross-functional partners, identify risks, recommend solutions, and drive alignment • Excellent written and verbal communication skills including strong presentation skills and the ability to present executive summaries in a concise manner • Ability to translate complex information into clear recommendations and actionable plans • Ability to effectively manage multiple priorities in a fast-paced environment • Flexibility and ability to embrace change • Experience with Submitters, Vendors and/or Receivers/Payers is a plus • Customer service and/or relationship management experience is a plus • Experience in software implementations is a plus

🏖️ Benefits

• Competitive salary • Bonus structure • Generous HSA company contribution • Healthcare, vision, dental benefits • 401k match program • Unlimited PTO for salaried associates + 9 paid holidays • Reimbursement up to $250/year for gym memberships, racing events, weight management programs, etc. • Education reimbursement • Paid Parental Leave for both moms and dads • Opportunities for community engagement and volunteering