EDI Operations Analyst - Encounters

Elevance Health; Latham (NY); Hybrid; USD 32,000 - 53,000; Full time

Job summary

Elevance Health, Inc. is seeking an EDI Operations Analyst I - Encounters in New York area. This hybrid role requires in-office 1-2 days per week and is open to alternate locations within commuting distance.

The position involves serving as a liaison for electronic connectivity, enrolling providers, educating on EDI, and coordinating with vendors on connectivity for the EDI system. A HS diploma or equivalent with claims or customer service experience is required.

Qualifications

• Requires HS diploma or equivalent with claims or customer service experience.
• Experience in claims or customer service preferred or equivalent background.
• Familiarity with EDI systems is beneficial.

Responsibilities

• Assist in developing or modifying claims filing procedures.
• Provide vendor specifications to vendors and clearing houses.
• Enroll providers for claims and encounter submission.
• Educate providers regarding EDI.
• Collaborate with vendors on EDI system connectivity.

Skills

Claims encounters experience

EDI knowledge

Vendor coordination

Education

HS diploma or equivalent

Job description

EDI Operations Analyst I - Encounters

Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The EDI Operations Analyst I is responsible for functioning as provider liaison for all electronic connectivity.

How You Will Make An Impact

• Assists in the development or modification of claims filing procedures, which includes the analysis of business and clients' needs and requirements.
• Provides vendor specifications to vendors and clearing houses.
• Responsible for enrolling providers for claims and encounter submission.
• Educates providers regarding EDI.
• Works with vendors regarding the implementation or connectivity related to EDI system.

Minimum Requirements

Requires a HS diploma or equivalent and any previous experience in claims or customer service; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities And Experiences

• Ability to conduct detailed research of claims, systems reports, understanding of network and telecommunications methodology preferred.
• Claims encounters experience strongly preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $23.46 - $38.71

Locations: Illinois; Maryland; New York; Virginia

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.