Director , Healthcare Payer Relations ( EDI, X12, operations, clearinghouse ) - United States
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• Bachelor’s degree in Business, Computer Science, or related field preferred.
• 7-10 years Health EDI experience
• At least 10 years prior connectivity, business analyst, or implementation experience in healthcare revenue cycle management software and technology (Health System, Payer, or Vendor)
• Direct people manager/supervisory experience highly preferred
Equivalent combination of education and experience may be considered.
Special Skills and Knowledge:
• Healthcare revenue cycle experience required
• Understanding of HL7 and X12 message/file formats and transactions
• Effective communication and relationship building skills
• Strong organizational skills, with ability to prioritize and execute tasks.
• Experience working in a team-oriented, collaborative environment
• Flexible, able to respond quickly to changes in project scope or timescales.
• Self-driven and highly motivated to be a high performing trusted resource within the organization.
• Proficient with tracking and managing multiple projects working with a variety of cross-functional resources (multi-tasking and prioritizing skills).
• Self-motivated, autonomous
Licenses, Certifications, etc.:
Knowledge
& Skills:
• X12 transaction knowledge with a focus on:
• 837
• 835
• 276/277
• 270/271
• 278
• Payer/Provider Enrollment process
• Payer EDI process
• API methods
• Experience writing and reviewing business, technical, and user non-functional/system level requirements
• 837
• 835
• 276/277
• 270/271
• 278
• Payer/Provider Enrollment process
• Payer EDI process
• API methods
• Experience writing and reviewing business, technical, and user non-functional/system level requirements
Education & Experience:
• Bachelor’s degree in Business, Computer Science, or related field preferred.
• 7-10 years Health EDI experience
• At least 10 years prior connectivity, business analyst, or implementation experience in healthcare revenue cycle management software and technology (Health System, Payer, or Vendor)
• Direct people manager/supervisory experience highly preferred
Equivalent combination of education and experience may be considered.
Special Skills and Knowledge:
• Healthcare revenue cycle experience required
• Understanding of HL7 and X12 message/file formats and transactions
• Effective communication and relationship building skills
• Strong organizational skills, with ability to prioritize and execute tasks.
• Experience working in a team-oriented, collaborative environment
• Flexible, able to respond quickly to changes in project scope or timescales.
• Self-driven and highly motivated to be a high performing trusted resource within the organization.
• Proficient with tracking and managing multiple projects working with a variety of cross-functional resources (multi-tasking and prioritizing skills).
• Self-motivated, autonomous
Licenses, Certifications, etc.:
WEDI, X12, HL7, CAQH CORE
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EOE including Disability/Veterans