EDI Implementation Analyst II

🔥 13 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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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

• Report to the Manager, Health Plan Implementation Analysts • Assess, analyze, and implement moderate to complex EDI solutions in a timely and efficient manner • Manage internal and external relationships with payers and vendors to meet integration objectives • Create, manage, and gain agreement on documented deliverables with internal and external partners • Coordinate partner awareness of Availity functionality and production issues • Manage implementations involving submitters, partners, vendors, EDI, B2B, web transactions, APIs, and other defined methods • Manage client timelines and deliverables, issue resolution, file transmission, response reporting, testing, and results delivery • Develop implementation plans, initiate them with customers, and create required execution tickets • Track multiple implementations using Availity tools and processes • Assess standard and non-standard implementations under HIPAA rules and Availity standards • Conduct pre-production functional testing and create and execute test plans • Mentor EDI Implementation Analysts and ensure timely project completion and adherence to Availity standards • Coordinate with Payer/Trading Partner, Vendor and Provider Marketing, Business Development, Business Technology Solutions, Product Management, Finance, and Operations • Coordinate communication between Availity platforms including HEW, Patient Access, and RCM • Provide implementation work estimates • Manage workflows and maintain implementation commitments • Represent Availity professionally to external customers • Assist Channels Sales, Account Management, and Payer Solutions with technical guidance • Drive clean handoffs to account management or operational support teams • Communicate new implementations and related changes with detailed specifications • Monitor customer communications for changes affecting business operations • Coordinate with technology and development teams to ensure requirements are met • Develop support documentation and document standard processes for continuous improvement • Document implementation requirements, test plans, contacts, and escalation procedures • Research, resolve, and document operational issues • Support implementation maintenance requests, connectivity changes, and edit/enrichment enhancements • Migrate clearinghouse partner configurations and specification documentation • Configure alternate routes for submitters • Update and maintain payer routing and payer lists, including route validation

🎯 Requirements

• Bachelor’s degree or the equivalent work experience • 4+ years of related experience in a technology (information exchange) and/or healthcare environment • 4+ years of experience managing simple to moderately complex implementations and delivering results with speed, accountability, and trust • Knowledge of the healthcare industry, specifically claims processing systems, provider office operations, and customer service processes in a healthcare company • 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, CCR/CCD • Ability to create and execute test plans • Ability to create documentation such as training resources and reference materials • Ability to establish and maintain effective working relationships with internal and external partners • Excellent written and verbal communication skills, including strong presentation skills and the ability to present concise executive summaries • Ability to manage multiple priorities in a fast-paced environment • Flexibility and ability to embrace change • Ability to prepare documented customer requirements • 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 • Sponsorship is not available for this position • Must be able to use a camera for all virtual meetings • Candidates are required to pass a drug test before beginning employment • Must satisfy United States employment eligibility verification requirements

🏖️ Benefits

• Competitive salary • Bonus structure • HSA company contribution • Healthcare benefits • Vision benefits • Dental benefits • 401k match program available on day one • Unlimited PTO for salaried associates + 9 paid holidays • Hourly associates start at 19 days of PTO, with the same holiday benefits • Wellness reimbursement up to $250/year for gym memberships, racing events, weight management programs, etc. • Education reimbursement • Paid Parental Leave for birth and adoptive parents • Diversity & Inclusion teams and employee groups • Continuous learning resources and industry/technology experts • Community volunteering and charitable engagement opportunities • Remote-first work environment • Camera/video capability for virtual meetings