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Claims Mgmnt Analyst III (HealthPlan EDI experience required)


Pay$70800.00 - $113200.00 / year
LocationDayton/Ohio
Employment typeFull-Time

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  • Job Description

      Req#: R8692
      Employer Industry: Healthcare Services

      Why consider this job opportunity:
      - Salary up to $113,200.00
      - Potential for bonuses tied to company and individual performance
      - Comprehensive total rewards package focused on employee well-being
      - Opportunity for career advancement and professional development
      - Engaging work environment that promotes inclusivity and collaboration
      - Chance to lead initiatives that improve healthcare operations and processes

      What to Expect (Job Responsibilities):
      - Manage EDI trading partners and network of clearinghouses for accurate information exchange
      - Collaborate with Vendor Management to enhance trading partner agreements and services
      - Provide Subject Matter Expertise on eBusiness specific EDI transactions across departments
      - Analyze existing processes and systems to develop solutions for efficiency improvements
      - Develop and document testing and validation processes as needed

      What is Required (Qualifications):
      - Bachelor’s degree or equivalent years of relevant work experience
      - Minimum of five (5) years of healthcare operations experience in insurance, managed care, or a related industry
      - Advanced knowledge of healthcare EDI files (e.g., 837, 270/271)
      - Exceptional communication skills and professionalism
      - Strong data analysis and trending skills, including query writing

      How to Stand Out (Preferred Qualifications):
      - Experience in health claims processing and managed care environments
      - Proven ability to interact effectively with all levels of management
      - Demonstrated leadership and relationship-building skills
      - Strong problem-solving and decision-making abilities
      - Ability to work independently and in team settings

      #HealthcareServices #EDI #CareerOpportunity #ProfessionalDevelopment #InclusiveWorkplace

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

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