Client Success Executive

6 hours ago

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HealthEdge

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Healthcare Insurance • SaaS • Fintech

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

1001 - 5000 employees

Founded 2005

⚕️ Healthcare Insurance

☁️ SaaS

💳 Fintech

📋 Description

• Act as a liaison between account teams, partners, and customer • Monitor and manage HIPAA-compliant EDI transactions (837, 835, 270/271, 276/277, 278, 820, etc.) • Collaborate with IT, Compliance, and Operations teams to troubleshoot, optimize, and enhance EDI workflows • Provide training and guidance to internal teams and clients on EDI processes and industry changes • Report EDI transaction success rates, rejections, and turnaround times.

🎯 Requirements

• Bachelor’s degree in Healthcare Administration, Information Systems, Business, or a related field • 5+ years of experience in healthcare EDI transactions, client management, or payer operations • Strong understanding of HIPAA 5010, ANSI X12, and other EDI transaction sets (837, 835, 270/271, etc.) • Strong knowledge of CMS, Medicaid, Medicare, and commercial payor regulations • Proficiency in EDI tools, SQL, data mapping, and reporting • Excellent communication, negotiation, and stakeholder management skills.

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Professional development