EDI Specialist II

HMA is one of the nation's largest administrators of high-quality, innovative, and affordable health plans and distinctive services for self-funded organizations. Employers trust HMA's team of caring experts to protect two of their most important assets; their people and their health plan dollars.In 2021, HMA was chosen as a Washington's Best Workplaces by our Staff and PSBJ™, and in 2022 we were awarded one of Seattle's Best Places to Work by BuiltIn. Our vision, 'Proving What's Possible in Healthcare®,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.What we are looking for: We are looking to hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team and helping others succeed, are motivated by tackling complex challenges, are courageous enough to share ideas, are action-oriented, are resilient, and are results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, benefits, and time off packages with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/How YOU will make a Difference: Leads the PBM and File Enroll EDI teams, overseeing daily activities for Ongoing Support, Renewals, and Implementation work. Reviews and implements operational processes and procedures to maintain existing SLAs with our internal and external clients. Works with Client Success & Sales, to gather EDI information for RFPs for net-new and existing clients.What YOU will do:

• Manages and leads the File Enroll & PBM projects, including documentation, quality assurance, production support, and workflow management.
• Coordinates with Stakeholders to prioritize and resolve issues identified for File Enroll & PBM integrations
• Develops and implements an EDI strategy to support organizational initiatives
• Supports problem-solving and troubleshooting work with external and internal clients to resolve challenges and escalations.
• Assists with daily tasks during high-volume periods in an effort to maintain SLA
• Completes UAT validation for both Implementation and Support deployments
• Works with Sales and Client Success to provide details for RFPs and up-sale opportunities
• Manages relationships with HRIS Vendors and PBMs in an effort to streamline and improve efficiency of implementations and ongoing support.
• Coordinates with the File Management teammates to gain a comprehensive view of end-to-end data transactions to offer seamless support during off-cycle and renewal changes.

Knowledge, Experience, and Key Attributes needed for Success:

• Bachelor's degree or equivalent experience required
• Previous experience in a Business Analyst or Project management role
• Customer Service-Oriented mindset, with the ability to convey complex technical concepts to non-technical individuals.
• Strong communication skills in order to effective communicate with internal and external clients
• Having advanced knowledge of Excel, word, and Outlook.
• Must possess analytical skills have the ability to troubleshoot
• 5+ years' Previous experience with EDI claims processing, HIPAA x 12 834 experience preferred
• Previous Edifecs experience, specifically file processing 834 is preferred

How we Support your Work, Life, and Wellness Goals:We offer a comprehensive total rewards package including: competitive pay; annual incentive; medical, dental, and vision insurance; 401K retirement plan with match; generous PTO and holidays; an onsite gym facility; a gym subsidy; Life, AD&D, Short-Term and Long-Term Disability Insurances; an Employee Assistance Plan; year-round wellness activities; the ability to earn a $500 wellness incentive; monthly events; paid volunteer hours and more! For local employees- free parking and easy freeway access to I-405 and I-520 and a well-stocked kitchen on-site with subsidized snacks and refreshments.HMA requires a background screen prior to employment.Protected Health Information (PHI) Access Healthcare Management Administrators (HMA) employees may encounter protect