EDI Data Exchange Manager in Boston, MA at Beacon Health Options

Date Posted: 12/1/2019

Job Snapshot

Job Description

About the Position:

Beacon Health Options is currently seeking a dynamic EDI Data Exchange Manager to join our team! The EDI Data Exchange Manager is integral to the day to day claims operations. The individual has a range of responsibilities beginning with the day-to-day ownership of the inbound claims process across all channels. This includes ensuring all inbound files are processed timely and accurately, providing audit, balance and control reporting and review.

The role will ensure that any fallout from the daily audit reporting are addressed.  Ensure all file errors are investigated and remediated in a timely fashion.  The individual will be expected to be a subject matter expert on the technical requirements on 837, 835, 277 and 999 EDI files.  Additionally the role will be responsible for daily file exchange inbound and outbound between Beacon and clients.  This includes ensuring the team is adhering to the agreed schedule with all client deliverables and providing solution leadership when necessary.  

Position Responsibilities:

  • Provide daily supervision of personnel, which includes work allocations, make recommendations for personnel actions and approve motivational plans and/or programs for individual development in order to operate at peak productivity and profitability
  • Provide technical direction for staff and deliver hands-on solutions as needed to meet prescribed turnaround times and quality requirements. 
  • Develop and maintain cohesive working relationships with internal and external customers to establish effective problem resolution and process improvement toward the achievement of exceptional service.
  • Create a partnership with key vendors in this area to ensure an environment of quick and accurate issue resolution. 
  • Develop and maintain an environment that encourages personal involvement in planning, communications, coaching and development of employees, sharing responsibilities and accountabilities to ensure effective contribution to corporate goals and objectives.
  • Perform strategic planning, development and communication with Senior Leadership as related to corporate goals and objectives.
  • Ensure there are effective performance management systems in place for measuring, analyzing and aligning to continuously improve overall performance levels in all areas of the operation.
  • Ensure employee education and training as well as quality audit programs are in place to support the service operation’s objectives, including building employee knowledge, skills and capabilities required to perform in their job function that will contribute to improved performance.
  • In partnership with Development, perform research and analysis on new technology opportunities, systematic enhancements and other efficiency/effectiveness related possibilities toward the goal of delivering ever improving service.

Position Requirements:

  • Education: High School Diploma or GED equivalent is required, Bachelor’s Degree in business is preferred
  • Relevant Work Experience: 8+ years of experience in leading people in the health insurance industry with an understanding of EDI exchanges and project management required
  • Travel: 5 – 10% required

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.