Manager - Payer Operations, Health - Remote
Manager - Payer Operations, Health - Remote
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Salary Not Disclosed
1 Vacancy
Job Description
Reporting to Experian Health the Manager Payer Operations will lead a team of EDI Analysts responsible for optimizing connectivity monitoring and ensuring operational excellence across electronic transaction workflows. The Manager will be an important escalation point guide process improvements and collaborate with all partners to ensure seamless payer integration and performance.
You will:
- Lead a team of EDI Analysts (Levels 13) assuring optimal performance and providing coaching for professional development.
- Oversee daily operations related to payer transaction monitoring and issue resolution.
- Ensure identification escalation and resolution of EDI transaction errors and connectivity issues.
- Coordinate with external trading partners and company partners to resolve issues
- Guide the development of EDI documentation and process documentation.
- Help implement automation and AI technologies to improve operational efficiency.
- Monitor team workload and performance metrics ensuring adherence to performance and service level expectations.
- Implement process improvements including documentation standards tooling enhancements and cross-training plans.
- Represent the team in meetings and industry forums.
- Maintain an understanding of healthcare EDI standards (270/271 835/) and evolving industry requirements.
Qualifications :
Education & Experience:
- Bachelors degree in business Computer Science Healthcare Administration or related field
- 5 years of experience in healthcare EDI payer operations or revenue cycle management required
- 2 years of direct people management experience overseeing technical or operational teams required
- Knowledge of X12 and HL7 transactions including 27x 83x and 278.
- Familiarity with payer/provider enrollment processes EDI protocols and API/web capture methods.
- Proficiency in Salesforce JIRA Microsoft 365 and data analytics tools (especially Excel).
- Experience with Agile methodologies (Scrum Kanban)
Additional Information :
Benefits/Perks:
- Great compensation package and bonus plan
- Core benefits including medical dental vision and matching 401K
- Flexible work environment ability to work remote hybrid or in-office
- Flexible time off including volunteer time off vacation sick and 12-paid holidays
- Explore all our exciting benefits here: uniqueness is that we celebrate yours. Experians culture and people are important differentiators. We take our people agenda very seriously and focus on what matters; DEI work/life balance development authenticity collaboration wellness reward & recognition volunteering... the list goes on. Experians people first approach is award-winning; Worlds Best Workplaces 2024 (Fortune Top 25) Great Place To Work in 24 countries and Glassdoor Best Places to Work 2024 to name a few. Check out Experian Life on social or our Careers Site to understand why.
Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range individual pay is determined by work location and additional factors such as job-related skills experience and education. You will be also eligible for a variable pay opportunity.
Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal state and local law including protected veterans and individuals with disabilities. Innovation is an important part of Experians DNA and practices and our inclusive workforce allows everyone to succeed and bring their whole self to work. If you have a disability or special need that requires accommodation please let us know at the earliest opportunity.
#LI-Remote
Remote Work :
Yes
Employment Type :
Full-time
Employment Type
Remote
Company Industry
Department / Functional Area
Customer Service
Key Skills
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