Client Implementation Analyst III (EDI) REMOTE

At MultiPlan, 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 of our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and upward!!! Ideal candidate may be located near our NYC office to be onsite few times a month. JOB SUMMARY: A Client Implementation Analyst is responsible for the electronic setup, testing and go-live of IT projects that involve Client Claims Processing. These claims may be received either via EDI (Electronic Data Interchange) or via Web Services (near real time technology). The analyst is involved end to end in the process to implement both new business workflows and existing products for all clients/trading partners, and is also the subject matter expert for internal initiatives on revenue generating and process improvement projects. JOB ROLES AND RESPONSIBILITIES: 1. Manage the efforts to fulfill a client request to access MultiPlan Products, and to customize how they access/utilize MultiPlan Products using EDI and Web Services claims processing workflows. It includes but is not limited to the below * 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 2. Test new and enhanced claims processing systems and complex EDI and Web Services processes * Participate in functional and technical design discussions for new features and system changes * Prepare test plans and build appropriate test cases * Perform analysis and document results * Manage defect resolutions, warranty releases * Propose enhancements and process improvements * Support deployments with smoke testing in multiple environments * Performing sanity, functional, volume, regression testing as required * Conduct necessary testing and in-depth business analysis to find and resolve any potential issues prior to deploying into the production environment. * Constructively present testing results and propose adjustments that will improve results for our clients/vendors and strengthen our ongoing partnership. * Monitor, audit, and report on the processing of newly implemented trading partners to confirm their successful transition to the production environment. 3. Act as the primary liaison between business and technical teams. * Build and maintain positive working relationships with internal colleagues (including IT, Sales and Marketing, and Operations) and external contacts. 4. Manage and coordinate IT deliverables to both internal and external stakeholders * Participate in implementation meetings with clients and vendors committed to establishing a partnership with MultiPlan. * Provide HIPAA-compliant guidance to clients requesting additional information about MultiPlan requirements and industry standards for EDI protocols. * Ensure proper setup of all systems that support file transfer and claims processing between MultiPlan and clients. * Work on standard as well as custom, non-standard projects on a daily basis including implementing clients who send proprietary format claim files. * Conduct necessary testing and in-depth analysis to resolve any potential issues prior to rolling clients into the production environment. * Constructively present testing results and propose adjustments that will improve service delivery to our clients and strengthen our ongoing partnership. * Monitor, audit, and report on the processing of newly implemented clients/features to confirm their successful transition to the production environment. * Support testing for rollouts of new products as well as internal system migrations. * Proactively prioritize, communicate, and resolve any process or system issues. * Analysis and reporting on client enquiries. Finding gaps and proposing viable solutions. 5. Manage requests and incidents using problem solving and critical thinking abilities * Promptly triage and resolve escalated EDI issues called into the Multiplan Service Desk. * Independently build and manage the monitoring requirements of clients on a daily, weekly and monthly basis. * Communicate system and interface availability, modifications, and problems to internal and external stakeholders as needed and according to established policies and procedures. * Support clients with their non-standard requests for ad hoc reports, testing analysis and other technical deliverables. 6. Implement process improvements to enhance the efficiency of claims workflows. * Partner with other IT teams to implement enhancements and defect fixes. * Report progress & measurements of implementation success to clients and all stakeholders. * Perform routine and ad hoc analysis of various facets of claims processing including but not limited to system performance, claim turnaround times, data mapping, and claim volumes. * Analyze data to identify potential process improvement opportunities. * Perform gap analysis, communicate and implement potential solutions. * Proactively remain informed on ever changing client specific business rules to ensure accuracy. 7. Prepare and maintain documentation that defines operational procedures, describes client requirements, and share relevant analysis outcomes with internal and external stakeholders. * Contribute to building and maintenance of knowledge repository on processes and procedures on a regular basis. * Present information learned as part of daily work with the larger team. 8. Exhibit excellent team work * Provide coverage and support for other team members as well as leads/managers. * Support Manager with team goals and corporate strategies. * Support deployment activities during release weekends if needed. 9. Good leadership and decision making skills * Train, mentor and coach junior team members. * Handle escalated issues and enquiries from less experienced team members. * Consistently articulates ideas, opinions and information and shares this in a timely manner with others. 10. Collaborate, coordinate, and communicate across disciplines and departments. 11. Ensure compliance with HIPAA regulations and requirements. 12. Demonstrate Company's Core Competencies and values held within. 13. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role. 14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. JOB SCOPE: The incumbent relies on experience and judgment to plan and accomplish goals. The incumbent works under general supervision to review systems and provide technical support and assists with escalated issues. JOB REQUIREMENTS (Education, Experience, and Training): * Minimum Bachelor's Degree, or HS Diploma and 4 years of related experience * Minimum 5+ years progressively responsible experience in a technical production or applications support role * Required licensures, professional certifications, and/or Board certifications as applicable * At least 5 years experience with EDI or similar file transfer protocols. * Experience of creating/writing Test Plan * Experience building test cases for back-end data processing * Solid understanding of Healthcare IT claims processing including: * FTP (File transfer protocols). * EDI and Web Services/ XML transactions. * Knowledge of HIPAA EDI 5010 X12 Transactions, 835, 837P and 837I * Advanced ability to create SQL queries utilizing multiple tables and datasets to analyze and evaluate EDI data within an Oracle database * Experience working with below * MS Word, MS Excel, PowerPoint. * Service Now, Confluence, JIRA. * Text editors like Ultraedit, Textpad, Notepad++. (Nice to have) * Applications like Specbuilder, Beyond compare, Tableau (Nice to have) * Exceptional analytic and troubleshooting skills * Superior customer service skills, preferably in a technical implementation capacity * Ability to work independently and as a member of a team * Clear and concise verbal and written communication skills * Clear understanding and working knowledge of HIPAA EDI protocols * In-depth understanding of x12 specifications * Ability to juggle multiple requests at once * Project Management experience desired * Understanding of internet applications and networks desired * Knowledge of Healthcare Business Systems desired * Experience with mapping tools such as Gentran, Pervasive or Claredi desired * Experience managing customer and/or vendor relationships desired * Mentoring experience desired * Technical writing experience desired * Ability to think creatively desired * Able to manage in an environment of changing desired COMPENSATION The salary range for this position is $100K to $110K. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. BENEFITS We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities. Your benefits will include: Medical, dental and vision coverage with low deductible & copay Life insurance Short and long-term disability 401(k) + match Generous Paid Time Off Paid company holidays Tuition reimbursement Flexible Spending Account Employee Assistance Program Summer Hours EEO STATEMENT MultiPlan is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here .

Created: 2024-11-05