Healthcare EDI and Insurance Discovery Team Lead (Remote)
Healthcare EDI and Insurance Discovery Team Lead (Remote)
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Salary Not Disclosed
1 Vacancy
Job Description
The Healthcare Revenue Cycle EDI and Insurance Discovery Team Lead oversees a team of Analysts responsible for Electronic Data Interchange (EDI) operations and healthcare insurance coverage verification. You will report to Experian Health and ensure the strategic agreement of data exchange with organizational goals oversees the implementation of scalable solutions and drive continuous improvement in operational efficiency and compliance and collaborate to support innovation product development and revenue cycle optimization.
Team Leadership & Strategy:
Lead mentor and develop a team of EDI and insurance discovery analysts.
Define team goals monitor performance and ensure alignment with departmental objectives.
Develop and implement strategic plans for EDI and insurance discovery initiatives.
Foster a culture of continuous improvement innovation and accountability
EDI Oversight:
Oversee the monitoring troubleshooting and optimization of EDI transactions (e.g./271 276/277)
Ensure accurate data exchange with internal systems and external trading partners
Collaborate with IT and vendors to resolve complex EDI issues and implement enhancements
Maintain documentation standards and ensure compliance with industry regulations
Insurance Discovery Management:
Guide the design and execution of insurance verification and discovery processes
Ensure data accuracy and integrity across systems through audits and quality checks
Partner with payers and clearinghouses to resolve escalated coverage issues
Support compliance and regulatory programs related to insurance data
Collaboration:
Serve as the primary liaison between the EDI insurance team and Revenue Cycle IT Compliance and Product
Provide subject matter expertise for new product development and system integrations
Lead training initiatives and knowledge-sharing efforts across the organization
Qualifications :
- Bachelors degree in Computer Sciences Healthcare Administration Information Systems Business or related field. Masters degree is beneficial
- 5 years experience in healthcare revenue cycle management with emphasis on EDI eligibility verification and insurance discovery operations EDI formats and standards X12 HL7
- 3 years experience in a leadership or supervisory role
- 5 years experience working with HIPAA regulated data regulation and policy payer-provider data interchange and healthcare data standards
- 3 years experience working with healthcare management systems (e.g. Epic Cerner) and clearinghouses
- 5 years experience with healthcare billing coding and insurance workflows
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
- Flexible time off including volunteer time off vacation sick and 12-paid holidays
- Explore all our exciting benefits here: Experian our people and culture set us apart. Were deeply committed to creating an environment where everyone feels they belong and can excel. From inclusion and authenticity to work/life balance development wellness collaboration and recognition we focus on what truly matters. Our people-first approach has earned us global recognition: Worlds Best Workplaces 2024 (Fortune Top 25) Great Place To Work 2025 in 26 countries and Glassdoor Best Places to Work 2024 among others.
Want to see what life at Experian is really like Explore Experian Life on social or visit our careers site.
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
This is a remote position.
Remote Work :
Yes
Employment Type :
Full-time
Employment Type
Remote
Company Industry
Department / Functional Area
Product Management
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