EDI Analyst

Join the frontlines of today's healthcare transformation 

We're looking for an IT EDI Analyst – Delegated Services who will support the technology enablement of VillageMD’s Delegated Services team as well as its transformation initiatives in the coming years.  At VillageMD, we are focused on transforming the way primary care is delivered and how patients are served and our contact center is one of the primary vehicles through which we engage patients. 

Why VillageMD? 

VillageMD is changing the trajectory of healthcare. We’re empowering primary care physicians to make informed decisions, and engaging patients in meaningful ways. We work with thousands of clinicians and healthcare disruptors across the country, improving patient health while driving down the cost to deliver it. 

We are a mission-oriented organization, and we are thrilled about the work that we accomplish every day. We’re transparent. Collaborative. Relentless in pursuit of our mission. With a confidence to lead but the humility to never stop learning. We believe that diverse backgrounds and experiences create the best opportunity for innovation. And we know that the community we are growing is greater than any one individual. 

We’ve built our technology using the best of cloud and open-source technologies to create an open, data-first platform that is enriched with analytical models and connected to the most modern internal and external apps. These apps drive clinical decision support, patient engagement and other facilitators of innovative, information-enriched health experiences.

Could this be you? 

See for yourself how the IT EDI Analyst – Delegated Services helps reshape successful healthcare with VillageMD: 

The IT EDI Analyst – Delegated Services will implement and maintain the functions and operations of the Delegated Services team. To analyze and implement new technologies supporting transformational growth within our care delivery model as it relates to our delegated functions. Contribute to the identification and prioritization of user issues and requests for new features by detailing user requests and identifying data pipeline, data quality, and workflow opportunities. Perform analyses supporting the identification of new opportunities in essential workflows and documenting both existing and future planned workflows.

How you can make a difference 

During your first year, you can expect the following professional challenges:  

• Assist in the implementation of multiple health plans onto our delegated services technology platform, EZCAP.
• Implement and operate user requests for new features with the broader technology team supporting the Delegated Services implementations and operations.
• Lead investigations into user reported issues within the Delegated Services technology stack communicating root cause with stakeholders while working internally on implementing the required enhancements.
• Understand and document the evolving needs for the maintenance, operation, and implementation of plans to the EZCAP system.
• Support routing design, analysis of new and existing capabilities, integration of third party applications with delegated services technology, and ensure the effective and highly reliable performance of our infrastructure and applications as our delegation footprint continues to meet evolving business goals and objectives.

Skills for success 

As a successful VillageMD I EDI Analyst you possess: 

• Knowledge of industry standard health data code sets such as ICD-9/ICD-10, CPT/HCPCS, and Revenue Codes and HIPAA and Affordable Care Act knowledge
• In depth knowledge of HIPAA/EDI X12 v5010 healthcare-related file formats including 820, 834, 835, 837, 270, 271, 276, 277, 278, 999, TA1
• Knowledge on encounter submissions for structural standard of data reporting for encounters
• Ability to identify and document data types, rules, mapping, and conversion requirements
• Provide analysis and audits of operational data, identify trends, and recommend operational solutions related to EDI
• Support and follow key work process flow for new service implementation, acquisitions, divestitures
• Experience performing requirements gathering, functional and data analysis, and system design and configuration
• Testing new and existing file transmissions to ensure accuracy
• Partnership and excellent vendor management communication
• The ability to create and refine processes that are adaptable and wildly scalable.
• Think clearly, communicate concisely, and collaborate always.
• Experience with claims adjudication software such as EZCAP, or similar.
• Familiarity with technical software and concepts- EzCap, Notepad++, Microsoft SQL Server Management Studio, CSV, XML
• Project management and document sharing software experience a plus (Jira, SharePoint, SmartSheets, etc.)
• Thrive in a fast-paced environment, find peace in chaos, and absorb information quickly to create a plan.
• A low ego: an ability to gain trust by doing what you say you will do. 
• Ability to work effectively in cross-functional teams.
• Flexible in approach to adapt when projects need it.

Experience to drive change 

• 2+ years working in Healthcare EDI or education equivalent to Healthcare Technology and concepts
• Experience with Medical Billing and Coding
• Knowledge of healthcare software, provider billing software, EHR/EMR
• Technical knowledge or background
• Advanced technical skills
• Excellent documentation skills
• SQL experience strongly preferred

How you will thrive 

• In addition to competitive salaries, a 401k program with company match, bonus and a valuable health benefits package, VillageMD offers paid parental leave, pre-tax savings on commuter expenses, and generous paid time off. You work in a highly-collaborative, conscientious, forward-thinking environment that welcomes your experience and enables you to make a significant impact from Day 1. This fun, fast-paced, startup environment even comes complete with snacks. 
• You also have the flexibility to contribute remotely. Most importantly, you make a difference. You see a clear connection between your daily work on VillageMD products and services and the advancement of innovative solutions and improved quality of healthcare for providers and patients.  

Our unique VillageMD culture – how inclusion and diversity make the difference 

• At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. 

For Colorado Residents only: The base compensation range for this role is $65,000 to $80,000. At VillageMD, compensation is based on several factors including but not limited to education, work experience, certifications, location, etc. This role may be eligible for annual/quarterly bonus incentives (if applicable), and the selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan with company match.