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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
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