Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
Position Summary:
The EDI Associate is responsible for establishing and maintaining electronic connections to insurance carriers, industry clearinghouses and collection agencies in support of athenahealth’s batch and real time transmission of health data. This includes eligibility checks, claim submissions, solicited and unsolicited acknowledgment reports, Claims Status Inquiries (CSI), remittance advices and collection files. In addition, the EDI Associate coordinates the implementation of changes to these EDI transactions, so as to comply with new payer requirements and execute on athenahealth’s EDI Strategy.
The EDI Associate is responsible for monitoring and maintaining appropriate quality standards. This includes utilizing analytic tools, problem solving skills, and stakeholder relationships to initiate and execute on projects to improve various transaction metrics. The EDI Associate is responsible for collaborating with payers, vendors, clients, and various internal teams to ensure the timely completion of these projects.
Essential Functions (Duties and Responsibilities):
- Managing communications with internal (athenahealth) and external (Insurance companies/Clearinghouses/Collection agencies) stakeholders.
- Organizing and executing small projects independently.
- Researching and implementing new EDI connections.
- Investigating and resolving Payer EDI issues, particularly those related to connectivity errors.
- Developing a comprehensive understanding of athenahealth’s revenue cycle management system in order to address cross-functional problems and influence solution design.
- Testing EDI file formats and connections.
- Monitoring daily, weekly, and monthly production and quality reports.
- Actively engaging in athenahealth’s teaching and learning culture.
Skills Required
- Strong communication skills and an ability to effectively engage with members across geographical teams.
- Strong problem solving and analytic skills.
- Strong verbal and written communication skills.
- Ability to manage problems through entire lifecycle from identification through to resolution.
- Proven ability to meet deadlines and adapt to changes in a fast-paced environment.
Preferred Skills
- Work experience within the US Healthcare industry, particularly in medical billing.
- Familiarity in SQL
- Familiarity with HIPAA X12 transactions or similar interoperability standards
- Familiarity with FTP, SFTP and VPN concepts
About athenahealth
Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
Our company culture: Our talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.
Our DEI commitment: Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers and the communities where we work and serve.
What we can do for you:
Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.
We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.
In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. We provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.
Learn more about our culture and benefits here: athenahealth.com/careers
https://www.athenahealth.com/careers/equal-opportunity
Top Skills
athenahealth Boston, Massachusetts, USA Office
80 Guest Street, Boston, MA, United States, 02135
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