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EDI Operations Sr. Analyst

Website Recuro Health

About Us

Recuro Health is building the future of digital health, and a world-class platform to support it. This role will support our internal sales organization and external clients within our fast-growing benefits division to ensure successful implementation of complex, sensitive, and high-profile enrollments by assisting in daily EDI processes, provide production support, and coordinate new EDI onboarding with the team. You’ll be part of a team managing implementations, monitoring EDI systems process, technical specification mapping, assisting in escalating issues, and performing ongoing maintenance for customers using EDI files.

General Responsibilities:

  • Analyze and coordinate customer requests for EDI file set-up looking for the suitability of billing type, plan design, and EDI benefit administration platform and communicate feedback in a timely manner.
  • Proactively monitor production files for quality, accuracy, design, or mapping issues to minimize interruptions. When issues arise, work with internal and external stakeholders to communicate status, manage expectations and resolution timelines, mitigate customer impacts, and lead the remediation process.
  • Serve as the primary point of contact to customers and benefit administration vendors on EDI interactions and develop strong working relationships with our TPA and employer group partners.
  • Serve as a subject matter expert and resource for internal operations for EDI workflow, process, and procedures.
  • Assist in identifying opportunities within the EDI process for service delivery, operational efficiencies, and effectiveness.
  • Assist in processing and monitoring all EDI and member eligibility for both inbound and outbound transactions.
  • Perform other duties as assigned

Qualifications and Education Requirements:

  • 3+ years insurance industry experience.
  • Experience with EDI documents and files in the health care industry; 837s and 834.
  • Demonstrated project management experience.
  • Strong communication skills

Physical Demands:

  • Ability to sit for extended periods of time and view a computer monitor (with or without blue-light filters) for shift duration, for up to 10 hours of time during a work day excluding meal and rest periods.
  • Ability to effectively see and read font size 6 and above with or without corrective vision.
  • Ability to use hands and fingers for complex tasks, such as typing and use of mouse
  • Ability to clearly hear information communicated in audio format.
  • Ability to use hands and type for shift duration for up to 10 hours of time excluding meal and rest periods.
  • Ability to maintain attention and concentration for extended periods of time
  • Ability to work from home with limited communication with the team.
  • High degree of pressure to meet deadlines, fast paced work environment, high degree of accuracy expected, self-motivated
Our Culture

Recuro is building a Product function that values passionate and talented team members, nimble problem solving, a supportive growth environment, relentless learning, innovative thinking, and accountable ownership to improve healthcare for people.

Equal Opportunity Employer

Successful applicants must be eligible to work in the US (visa sponsorship is not provided at this time) and must be able to pass a pre-employment background test. Recuro Health is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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