EDI Implementation Analyst

Company Introduction

Availity is one of the leading health information networks in the United States, processing more than 4 billion transactions annually and connecting more than two million healthcare providers and over two thousand technology partners to health plans nationwide. Our teams of technology, business, and customer service professionals in Bangalore, India, are working together to transform healthcare delivery in the United States through innovation and collaboration. Our technologists help develop cutting-edge revenue cycle solutions that help hospitals, health systems, and physicians maximize payments and optimize their workflows.

Availity is a diverse group of people whose talents, curiosity and passion steer the company to create innovative solutions for the US Healthcare industry. If you are a driven, creative and collaborative individual, with exceptional technology skills to drive innovation, we want to hear from you.

Job Description

Availity is a Healthcare IT company headquartered in Jacksonville, FL, with additional offices in Indianapolis, IN, and Bangalore, India, and a significant remote workforce throughout the US. Availity is the nation's largest health information network, connecting over 2 million providers with health plans nationwide and processing more than 12 billion transactions a year, and growing! We work collaboratively with health plans and providers to disrupt an antiquated healthcare system by offering solutions that solve core issues in how these stakeholders communicate. Availity also provides revenue cycle management solutions to help providers, hospitals, and health systems receive accurate, timely payment for their services.

As the premier healthcare engagement platform, our mission is to create connections and deliver products that help healthcare businesses succeed. We connect, delight, and empower the nation's premier healthcare ecosystem, providing multi-stakeholder solutions that simplify the business relationship between providers and health plans.

The EDI Implementation Analyst provides support in researching, resolving, and documenting simple, standard processes or issues with system configuration and/or submitter and receiver integrations. The role is accountable for assessing, analyzing, and implementing solutions in a timely and efficient manner. The Analyst collaborates with internal and external partners, providers, and vendors by providing feedback, escalating issues as appropriate, creating documentation and managing deliverables. The Analyst may assist other teams in coordinating partner awareness on Availity functionality and production issues as requested by internal teams. The Analyst will also be required to carry out other duties, projects, or activities as specified by their management.

Sponsorship, in any form, is not available for this position.

Roles & Responsibilities

Why you want to work on this team:

• You will be working with a tight-knit, collaborative team
• You will have the ability to work independently and have the support of a well-tenured team behind you

To be qualified for this position:

• 3 years related experience in a technology (information exchange) and/or health care environment
• Associate degree in Computer Science or a related technology field or 1.5 years of technology experience would be considered in lieu of degree
• Knowledge of EDI and real-time transaction processing
• Working knowledge of X12 transactions; specifically, 837P, 837I, 835, 270/271, 275, 276/277, 278
• Understanding of HIPAA implementation guides for claim and other transactions
• Prior experience with SQL
• Ability to create and execute test plans
• Problem solving skills, strong analytical skills, ability to multi-task
• Ability to establish and maintain effective working relationships, supporting internal and external partners
• Ability to collaborate with external partners and internal partners including production support teams and information technology
• Excellent written and verbal communication skills including strong presentation skills and the ability to present executive summaries in a concise manner
• Ability to create documentation such as training resources and reference materials
• Demonstrated ability to use discretion and make sound decisions
• Ability to effectively manage multiple priorities in a fast-paced environment
• Flexibility and ability to embrace change
• Knowledge of the health care industry specifically claims processing systems, provider office operations, and customer service processes in a health care company

You will set yourself apart:

• Experience working with healthcare and / or internet applications
• Experience with Submitters, Vendors and/or Receivers/Payers
• Customer service and/or relationship management experience
• You enjoy collaboration and thrive working in a team environment.
• You have some experience in software implementations.

You will be doing:

• Setup and installation of technical systems, applications, or process designs for client's purchased or outsourced technology and business process solutions
• Work directly with clients to manage initial access, map and transfer data, create process documentation, and train or coordinate training for client users
• Testing and troubleshooting functionality of installed systems
• Identifying and documenting technical issues to be escalated to product and system integration teams for resolution
• Providing feedback based on client experiences to product and professional services teams for product and process improvements
• Potential work directly with clients on-site or provide installation support remotely.

Implementation:

• Accounting for all complexity level implementations, to exchange all transaction types through methods such as EDI, B2B, web transactions, API, and others as defined implementations. Tasks involve managing timelines and deliverables, issue resolution, file transmission, response reporting, testing and results delivery based on customer requirements using Availity processes and tools
• Assessing and analyzing moderately complex standard and non-standard implementations, including HIPAA rules and Availity standards and options and follows processes accordingly
• Partnership with external and internal stakeholders, the Connectivity Solutions Analyst conducts pre-production functional testing protocols, including creating and executing test plans for the implementation
• Tracking progress of specific implementation projects via Availity tools including JIRA, Confluence and Salesforce

Customer Relationship Management:

• Interacting with business, technical, internal and external resources on new and existing implementation solutions and partners. The Connectivity Solutions Analyst will be required to represent the company in a professional manner to external customers with supervision as needed.
• Communicating and coordinating between all Availity platforms
• Communicating new implementations and all related changes including detailed specifications
• Monitoring customer communications (submitter, payer, trading partners, etc) to be apprised of any changes that may impact business operations (new edits, connectivity updates, system downtime)
• Interacting closely with other technology teams and development staff to ensure requirements able to be met accurately and executed within the expected timeline for the implementations.

Monitoring and Evaluation:

• Understanding profitability and loss; supports and communicates implementation decisions that have a positive benefit to the company
• Providing departmental level reporting, communications and presentations of key connectivity solutions

Process Documentation and Improvement:

• Leading in the development of Availity support documentation (such as production issues, impact and solution as it relates to the responsibilities of the Connectivity Solutions Analyst).
• Documenting moderately complex standard processes (such as standard testing procedures) as necessary for continuous process improvement
• Documenting all information related to assigned implementations. Including but not limited to payer implementations, such as requirements, test plans, contact information, escalation procedures, etc.
• Supporting process improvement of workflow, endeavors to stay current with technology trends, industry standards, and Availity strategy - specifically driving close to cash process for faster and higher quality connectivity solutions.

Customer Support and Issue Resolution

• Providing support to Connectivity Solutions Analyst for operational issues where assistance is needed.
• Supporting organization thru researching, resolving and documenting operational issues. Must be able to communicate simple to medium business, technical, and HIPAA issues and resolutions
• Supporting and maintaining implementations by execution of customer maintenance requests including but not limited to connectivity changes, and for updating and maintaining payer routing and the payer list to ensure data is accurate. Including validation of payer routes to guarantee satisfaction.
• Responsibilities of support for a Connectivity Solutions Analyst include but are not limited to the migration of clearinghouse partner configurations, migration of clearinghouse partner specification documentation, configuration of alternate routes for submitters.

Availity culture and benefits:

• Availity is a certified "Great Place to Work"! Culture is important to us and there are many ways for you to make your mark here!
• We have several Diversity & Inclusion teams, a Young Professionals Group, a She Can Code IT group for women in tech, and various ways to engage with fellow Availity associates.
• Availity is a culture of continuous learning. We have many resources and experts in our tech stack and in our industry that can help get you there too!
• Don't feel like wearing business attire? Cool, you can wear jeans - we are a casual place.
• Availity offers a robust total rewards package that is competitive and meaningful. We offer a competitive salary and bonus structure. We offer two different types of medical plans: a HDHP plan that has the lowest permitted deductible allowed by the IRS with a generous HSA company contribution and a PPO plan with a low deductible and out of pocket maximum. In addition, Availity offers two dental plans including orthodontia care (even for adults), vision, Employee Assistance Program (EAP), pet care, legal/ID shield services and a 401k match program that you can take advantage of on day one!
• We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.
• Interested in wellness? We allow our associates to reimburse up to $300/year for gym memberships, participation in racing events, weight management programs, etc.
• Interested in furthering your education? We offer education reimbursement!
• Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.
• Want to work for an organization that gives back to the community? You're at the right place! Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign. Each associate has 1 paid day per year to volunteer at the non-profit charity of your choice.

Availity perks for remote, hybrid and office-based associates:

• We offer a flexible working environment! Whether you are a fully remote associate or one that enjoys a hybrid or fully onsite approach we are flexible to help ensure you have a working environment to thrive in!
• Don't feel like going too far to eat? We occasionally have food trucks at our Jacksonville Office as well as food available for purchase in our cafe and an onsite cafe next to our Indianapolis office
• We also have onsite Fitness Centers with showers for our Jacksonville & Indianapolis offices and an annual Wellness reimbursement you can use for a gym membership, classes, sports activities, etc.
• We appreciate work/life balance! Need to get a quick break in between meetings? We offer online Yoga, virtual total body condition classes, step challenges, and health and wellness courses and in our Jacksonville office, we have Ping Pong, Foosball, Arcade games, and XBox to help you decompress - and we have a massage therapist onsite once a week for a little relaxation too
• We've got you covered with free coffee, lemonade and tea anytime you want in Jacksonville

Next steps:

After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process.

Interview process:

• Recruiter Phone Screen
• Manager resume review
• Manager video interview

Team video interview

Eligibility