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Associate, Group EDI

Headquarters Office, Schenectady, New York, United States of America Req #148
Wednesday, July 3, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.

Status: Full-time, Non-Exempt    

       


Summary:      


The Group EDI Associate is responsible for the coordination of all EDI enrollments
and eligibility functions including but not limited to implementation,
processing, reconciliation, and quality control. Identify any errors within the
EDI process and coordinate with internal and external customers for resolution.
The associate will work directly with internal and external customers. Ensure new EDI groups meet MVP’s current mapping procedures
to maintain operational efficiencies. Respond to eligibility inquiries related
to Group EDI membership. Assist new and existing EDI clients with any
questions. Process any manual membership updates received by email and/or
queues and follow-up with vendor to ensure updates are reflected in their
eligibility files. Maintain and complete all reporting of ASO/EDI transactions
and schedules to ensure all performance guarantees are met. Ability to navigate
and utilize multiple systems for processing. Responsible for identifying
trending errors and implement solutions with internal and external customers.

Serve as a team player in supporting the departmental goal of a high level of
customer service through continuous quality improvement. Maintain departmental
standards of production levels and quality scores. Facilitate
implementation meetings with external and internal areas. Occasional Overtime
as required.
Perform other duties as assigned.

 

 

­­­Education/Degree: 

Associates degree preferred.  Equivalent amount of education and related experience may be considered.

 

Experience:

1-2 years’ experience in benefits, insurance, or healthcare. Familiarity with healthcare benefits

and/or medical terminology. Prior experience with 834 EDI file layouts strongly preferred.

 

Required Skills: 

  • Strong problem solving, analytical, and organizational skills required.

  • MS Word and Excel experience required.

  • Strong attention to detail

  • Experience in positions where adherence to strict confidentiality is required.

  • Must be able to work independently.

  • Excellent written and verbal communication skills.

 
Preferred Skills: 
 MS Access experience is strongly preferred.
 
 

MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

Other details

  • Job Family Enrollment and Eligibility
  • Pay Type Hourly
  • Headquarters Office, Schenectady, New York, United States of America