Client Implementation Analyst III (EDI) Remote

Client Implementation Analyst III (EDI) Remote

Join to apply for the Client Implementation Analyst III (EDI) Remote role at Claritev.

About Claritev

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple – we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external – driving us to consistently exceed expectations. We are bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. We are on a transformational journey to become a leading technology, data, and innovation voice in healthcare.

Responsibilities

• Manage the efforts to fulfill a client request to access Claritev products, and to customize how they access / utilize Claritev Products using EDI and Web Services claims processing workflows. This includes, but is not limited to :
• Understanding client needs
• Researching current client setup & claim processing rules
• Designing the quickest and most efficient solution
• Communicating effort, timelines, risk and client impact
• Implementing the solution and validating that it works as intended
• Performing end-to-end client-facing and regression testing
• Enabling client solution in the production environment
• Monitoring / Reporting / Turnover to Production Support
• Acting as the primary liaison between business and technical teams
• Building and maintaining positive working relationships with internal colleagues (IT, Sales & Marketing, Operations) and external contacts
• Managing IT deliverables to internal and external stakeholders
• Participating in implementation meetings with clients and vendors committed to a partnership with Claritev
• Providing HIPAA-compliant guidance to clients about Claritev requirements and industry standards for EDI
• Ensuring proper setup of all systems that support file transfer and claims processing between Claritev and clients
• Working on standard and non-standard projects, including implementing clients who send proprietary format claim files
• Conducting testing and in-depth analysis to resolve issues prior to production rollout
• Presenting testing results and proposing adjustments to improve service delivery
• Monitoring, auditing, and reporting on the processing of newly implemented clients / features to confirm successful production transition
• Supporting testing for product rollouts and internal migrations
• Prioritizing, communicating, and resolving process or system issues
• Analyzing client inquiries, identifying gaps, and proposing viable solutions
• Managing requests and incidents with problem solving and critical thinking
• Triaging and resolving escalated EDI issues called into the Claritev Service Desk
• Independently building and managing daily, weekly, and monthly client monitoring
• Communicating system / interface availability, changes, and issues to stakeholders per policy
• Supporting non-standard client requests for ad hoc reports, testing analysis, and other technical deliverables
• Implementing process improvements to enhance claims workflows
• Collaborating with other IT teams to implement enhancements and defect fixes
• Reporting progress and measurements of implementation success to clients and stakeholders
• Performing routine and ad hoc analysis of claims processing, including system performance, turnaround times, data mapping, and volumes
• Analyzing data to identify potential process improvements
• Performing gap analysis and implementing potential solutions
• Staying informed on changing client business rules to ensure accuracy
• Preparing and maintaining documentation that defines operational procedures and client requirements
• Contributing to the knowledge repository on processes and procedures
• Presenting learnings to the team and collaborating effectively
• Exhibiting strong teamwork and providing coverage for teammates as needed
• Supporting the Manager with team goals and company strategies
• Assisting with training and coaching of junior team members
• Supporting deployment activities during release weekends if needed
• Collaborating across disciplines and departments while ensuring HIPAA compliance
• Demonstrating Claritev's core competencies and values
• Note : Due to exposure of PHI sensitive data, this role is considered High Risk

Qualifications

Soft Skills

Compensation

The salary range for this position is $100K to $110K. Offers consider education, experience, skills, location, and internal equity. This role is eligible for health insurance, 401(k) and bonus opportunities.

Benefits

We offer competitive compensation and benefits packages, including an incentive bonus program, and opportunities for professional development. Our environment emphasizes flexibility and career advancement.

Your Benefits Will Include

EEO STATEMENT

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration regardless of age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. For more info on EEO rights, click here.

APPLICATION DEADLINE

We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.

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