HPC · 3 days ago
EDI Manager
Maryland Heights, MO
Full-time
Onsite
Senior Level
5+ years expHealth Payer Consortium (HPC) is a high-growth healthcare company that values its employees and fosters a supportive work culture. The EDI Manager will oversee multiple EDI-related projects, manage a small team, and ensure alignment with business objectives while collaborating with cross-functional teams to drive innovation in the healthcare space.
BillingHealth CareHealth InsuranceInsurance
Responsibilities
Manage several EDI projects concurrently from initiation to completion
Coordinate the HPC EDI team (currently three members)
Develop project plans, timelines, and deliverables for each initiative
Coordinate with internal teams, vendors, and stakeholders to ensure project goals are met
Monitor project progress, identify risks, and implement mitigation strategies
Communicate status updates and project outcomes to leadership and stakeholders
Ensure all projects are delivered on time, within scope, and within budget
Support a collaborative, high-energy office culture and participate in company events
Qualification
Required
Certified Health Claims EDI Specialist designation
5+ years experience in healthcare EDI with a technical understanding of healthcare EDI operations: receiving and transmitting 837 files; monitoring all EDI inventory and ensuring timely processing and return of claims
Quality assurance experience trouble shooting claims flow issues
Proven ability to manage multiple large-scale projects simultaneously
Proven ability to manage people towards a common goal
Strong analytical, organizational and time management skills
Excellent written and verbal communication skills
Proficiency with project management tools (and MS Office Suite - especially Excel and PowerPoint)
Ability to work effectively in a fast-paced, team-oriented, in-office environment
Preferred
2+ years of Project Management experience (PMP certification and experience with Monday.com are both bonuses)
Experience with healthcare EDI x12 transactions and healthcare claims
Medical coding certification (CPC, CCS, etc.)
Experience reviewing provider claims for technical errors
Familiarity with claims editing software/rules (unbundling, DRG, appeals)
Familiarity with healthcare compliance and data security requirements
Experience with a cost containment company
Extra Bonus if you have a music background, play an instrument or just LOVE live music
Benefits
Full benefits package
401(k) with company match
PTO, paid holidays, and more
If you prefer to work through your lunch break, we’ll provide lunch for you each day
Mentorship Program
Advancement and training opportunities
An amazing team that loves to celebrate wins
Company
HPC
Health Payer Consortium is a healthcare cost containment firm headquartered in St. Louis, MO.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase