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EDI Coordinator

2 months ago

Minneapolis, Minnesota, United States Gravie Full time

**About Gravie**

Gravie is a leading provider of innovative health benefit solutions that empower consumers to take control of their healthcare. Our mission is to revolutionize the way people purchase and access healthcare through cutting-edge products and services.

**The Role**

We are seeking an experienced EDI Claims Coordinator to join our team. As an EDI Claims Coordinator, you will play a critical role in ensuring the smooth operation of our claims management system. Your primary responsibility will be to oversee the internal production and support process of the adjudication and reporting of medical and Rx claims.

**Key Responsibilities**

  • Oversee and monitor all inbound and outbound EDI transfers within our claims management system, including claims, eligibility, and financial transactions.
  • Support the day-to-day operations of EDI, including identifying and resolving technical issues.
  • Run, schedule, and monitor EDI jobs from our claims management system, Javelina.
  • Analyze business needs and design and implement efficient data exchanges internally and with external vendors and partners.
  • Recognize and facilitate process improvement efforts as opportunities present.
  • Lead innovation by improving processes and procedures to ensure compliance with regulatory requirements, including HIPAA standards for PHI protection and transmission.
  • Collaborate with cross-functional teams to support operations and organizational needs.

**Requirements**

  • An associate's degree or equivalent work experience.
  • Experience in processing/outsourcing services for payor or self-insured groups.
  • In-depth working knowledge of ANSI X12 EDI files, such as 270/271, 276/277, 834, 837, 999.
  • Experience in identifying, repairing, and solving technical issues with EDI transactions.
  • Experience with SQL and relational databases.
  • Excellent verbal and written skills and decision-making abilities.
  • Able to organize, problem-solve, and prioritize multiple tasks.
  • Positive, professional attitude.
  • Ability to work independently and within a team environment.
  • Ability to respect and maintain confidentiality and HIPAA guidelines.
  • Working knowledge of computer-based word processing and spreadsheet packages; proficiency with MS Office products.

**Preferred Qualifications**

  • TPA experience.
  • Javelina experience/administration.
  • Claims processing and claims payment experience.
  • Knowledge of medical terminology.
  • Previous startup company experience.
  • Previous experience having worked at or with an Electronic Clearing House.
  • EDI certifications.

**What We Offer**

Gravie offers a competitive compensation package, including alternative medicine coverage, flexible PTO, 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave.