Manager-EDI (Remote)

American Specialty Health Incorporated; United States; Remote; USD 80,000 - 110,000; Full time

Job summary

An established industry player is looking for a dynamic Manager-EDI to lead a team within their IT department. This role involves overseeing the design, development, and implementation of transactions and reports to ensure compliance with HIPAA standards. You will streamline reporting processes and manage the timely submission of claims, while also developing a robust reporting architecture to meet current and future needs. Join a forward-thinking organization where your contributions will significantly impact the efficiency and effectiveness of health plan operations.

Qualifications

• Experience in managing teams and directing IT projects.
• Strong knowledge of HIPAA transaction set processing.

Responsibilities

• Manage and support a team of programmers and analysts.
• Design solutions for HIPAA transaction set processing.

Skills

HIPAA Compliance

Team Management

Systems Analysis

Problem Solving

Reporting Architecture

Education

Bachelor's Degree in Information Technology

Master's Degree in a related field

Tools

EDI Software

Data Analysis Tools

Job description

Description

American Specialty Health Incorporated is seeking a Manager-EDI to join our Information Technology (ITD) department. This position will manage, direct, and support a team of programmers and analysts to design, develop, and implement transactions, mappings, and reports to ensure compliance with HIPAA transaction set processing. Responsibilities include designing solutions to problems, developing testing procedures for HIPAA transaction set processing, performing gap analyses, and supporting systems analysis and design solutions for timely loading of Health Plan eligibility, benefit, and group information. The role also involves streamlining reporting processes, managing the timely submission of claims and encounter data, and overseeing reporting functions such as provider reporting, GEOACCESS, and capitation exception reports. The aim is to standardize and streamline reporting processes and develop a robust reporting architecture for current and future needs.