job summary: EDI Implementation Specialist
The EDI Implementation Specialist role is technical in nature and requires a strong understanding of the interaction between the Our systems and Our customers, both from a submitter and receiver perspective. The Connectivity Solutions Analyst role focuses on moderate to complex implementation tasks and responsibilities. The role is accountable for assessing, analyzing, and implementing solutions in a timely and efficient manner. Key responsibilities include, but are not limited to a) managing internal and external relationships with partners, providers, and vendors to meet integration objectives; b) creating appropriate documented deliverables, managing deliverables, gaining agreement from internal and external partners; and c) coordinating partner awareness on Our functionality as requested by Product Management and production issues as requested by internal teams, including but not limited to Operations support team and/or Information Technology team. The Connectivity Solutions Analyst is responsible for executing and maintaining implementation processes for moderate to complex initiatives and training internal and external stakeholders of those processes. The Connectivity Solutions Analyst is capable and responsible for performing all roles and responsibilities of the Connectivity Solutions Support Specialist when needed. The Connectivity Solutions Analyst assists the Sr. Connectivity Solutions Analyst with more complex projects. This position will be called upon to serve in multiple roles in a fast-paced, entrepreneurial corporate environment.
location: Jacksonville, Florida
job type: Permanent
salary: $65,000 - 75,000 per year
work hours: 9 to 5
education: No Degree Required
- Accountable for all complexity level implementations, including but not limited to submitters, partners, and vendors; to exchange all transaction types through methods such as EDI, B2B, web transactions, API, and others as defined implementations. Tasks involve managing client timelines and deliverables, issue resolution, file transmission, response reporting, testing and results delivery based on customer requirements using our processes and tools
- Acts under the guidance of the Sr. Connectivity Solutions Analyst
- Will be responsible for Connectivity Solutions (and Connectivity Solutions Support Specialist when needed) Analyst level tasks of all implementations. Including, but not limited to, developing the implementation plan for all new implementation requests (submitter, direct receiver/payer, and partner and vendor), initiating implementation plan with customer, creating all tickets required to execute implementation plan completely.
Implementation Tracking and Execution:
- Manages multiple moderate to complex implementations, including timelines, issue resolution and results delivery using our standard tools and processes
- Assesses and analyzes moderately complex standard and non-standard implementations, including HIPAA rules and our standards and options and follows processes accordingly
- In partnership with external and internal stakeholders, the Connectivity Solutions Analyst conducts pre-production functional testing protocols, including creating and executing test plans for the implementation
- Tracks progress of specific implementation projects via Our tools including JIRA, Confluence and Salesforce
- Mentors Connectivity Solutions Support Specialist to ensure projects are completed on a timely basis and ensures Our standards are followed.
- Interacts with Payer/Trading Partner, Vendor and Provider Marketing, Business Development, Business Technology Solutions, Product Management, Finance, and Operations
- Communication and coordination between all Our platforms- (HEW, Patient Access, RCM)
- The Connectivity Solutions Analyst will be engaged in providing estimates of work for implementations for submitters, partners and vendors when required.
- The Connectivity Solutions Analyst is responsible for managing the workflow of moderate to complex implementations and any other responsibilities of the Connectivity Solutions Analyst and ensuring all commitments are maintained.
Customer Relationship Management:
- Interacts with business, technical, internal and external resources on new and existing implementation solutions and partners. The Connectivity Solutions Analyst will be required to represent the company in a professional manner to external customers with supervision as needed.
- Assists the Channels Sales, Account Management, and Payer Solutions staff in finalizing opportunities by providing technical guidance to external stakeholders.
- Ensures market validation (utilization) of solution by driving clean hand off to account management or operational support teams.
- Communicates new implementations and all related changes including detailed specifications
- Monitors customer communications (submitter, payer, trading partners, etc) to be apprised of any changes that may impact business operations (new edits, connectivity updates, system downtime)
- Interacts closely with other technology teams and development staff to ensure requirements able to be met accurately and executed within the expected timeline for the implementations.
Monitoring and Evaluation:
- Understands profitability and loss; supports and communicates implementation decisions that have a positive benefit to the company
- Evaluates work products of Connectivity Solutions Support Specialist and assists where necessary.
- Proactively monitors production systems to ensure production issues are resolved in a timely manner
- Provides departmental level reporting, communications and presentations of key connectivity solutions
- Drives connectivity solutions to revenue generation, ensuring customer awareness, marketing and operational support are in place
Process Documentation and Improvement:
- Leads in the development of Our support documentation (such as production issues, impact and solution as it relates to the responsibilities of the Connectivity Solutions Analyst).
- Documents moderately complex standard processes (such as standard testing procedures) as necessary for continuous process improvement
- Responsible for documenting all information related to assigned implementations. Including but not limited to submitter and partner and vendor implementations, such as requirements, test plans, contact information, escalation procedures, etc.
- Supports process improvement of work flow, endeavors to stay current with technology trends, industry standards, and Our strategy - specifically driving close to cash process for faster and higher quality connectivity solutions.
Customer Support and Issue Resolution
- This role is required to provide support to Connectivity Solutions Analyst for operational issues where assistance is needed.
- Supports organization thru researching, resolving and documenting operational issues. Must be able to communicate simple to medium business, technical, and HIPAA issues and resolutions
- Supports and maintains implementations by execution of customer maintenance requests including but not limited to change requests, connectivity changes, and edit and enrichment enhancements.
- Responsibilities of support for a Connectivity Solutions Analyst include but are not limited to the migration of clearinghouse partner configurations, migration of clearinghouse partner specification documentation, configuration of alternate routes for submitters.
- Connectivity Solutions Analysts will also be responsible for updating and maintaining payer routing and the payer list to ensure data is accurate. Including validation of payer routes to guarantee satisfaction.
EDUCATION AND EXPERIENCE
- Bachelor's degree or the equivalent work experience
- Minimum of 4 years related experience in a technology (information exchange) and/or health care environment
- Experience working with healthcare and / or internet applications
- Minimum of 4 years' experience with managing simple to moderately complex implementations and delivering results with speed, accountability and trust a plus
- Experience working in an entrepreneurial company. Possess a working knowledge of the X12 transaction sets a plus
- Experience with Submitters, Vendors and/or Receivers/Payers a plus
- Customer service and/or relationship management experience a plus
- Some experience in software implementations a plus
skills: SKILLS AND KNOWLEDGE
- Ability to create and execute test plans
- Problem solving skills
- Strong analytical skills
- Ability to establish and maintain effective working relationships, supporting internal and external partners
- Ability to collaborate with external partners and internal partners including production support teams and information technology
- Excellent written and verbal communication skills including strong presentation skills and the ability to present executive summaries in a concise manner
- Ability to create documentation such as training resources and reference materials
- Demonstrated ability to use discretion and make sound decisions
- Ability to work under pressure. Maintains composure and professionalism in an interrupt-driven environment
- Must be able to multi-task
- Ability to effectively manage multiple priorities in a fast paced environment
- Flexibility and ability to embrace change
- Basic proficiency using PC skills and MS Suite products. Must possess a basic proficiency using email and electronic scheduling calendars
- Knowledge of the health care industry specifically claims processing systems, provider office operations, and customer service processes in a health care company
- Relationship management and collaboration skills
- Ability to work independently with minimal guidance. Focus on accountability for issue resolution.
- Understanding of HIPAA implementation guides for claim and other transactions
- Knowledge of the health care industry HIPAA mandated ANSI transaction formats.
- Must have a working knowledge of the X12 transactions specifically 837P, 837I, 835, 270/271, 276/277, 278, CCR/CCD, and HL7 transaction sets
- Proven ability to work in a team environment
- Ability to prepare documented customer requirements
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.