<p>Location: Minneapolis, MN</p><br/><p>Employment Type: Full Time</p><br/><p>Team: Engineering</p><br/><div><span style="font-size: 16px">Hi, we’re Gravie, and we are building the health plan of the future. For the past few decades, the health insurance industry has evolved to serve the needs of employers, insurance companies, brokers, and (sometimes) doctors and hospitals. The needs of the consumer, however, have largely been left out of the equation. We’re changing that. We are rebuilding the entire health insurance stack, with the consumer as the central focus. Our goal is to create a health plan that people can love.</span></div><div><span style="font-size: 16px">&nbsp;</span></div><div><span style="font-size: 16px">At Gravie, you’ll get to do things every single day to support making health benefits easy to understand and simple to navigate. You’ll work at a startup that has demonstrated amazing growth and our future is only getting brighter. We're past the risky early stage, but have only put a dent in the incredible innovations to come. And you’ll join a hugely talented and passionate team. After all, you are our competitive advantage. Our industry-changing products and services couldn’t exist without our talented people thinking about how to make healthcare benefits better every single day. It takes unique people on diverse teams to deliver the kinds of results we deliver. We encourage you to be your authentic self - we like you that way.</span></div><div><br></div><div><b style="font-size: 16px">A Little More About The Role</b><span style="font-size: 16px">:&nbsp;</span></div><div><span style="font-size: 16px">The Claims EDI Coordinator oversees the internal production and support process of the adjudication and reporting of medical and Rx claims. They will work closely with other departments to proactively research concerns and resolve issues. The person will handle EDI file management for all aspects of the claims administration system, queries, reporting, process enhancement, and play a key role in making sure we’re serving our clients to the Gravie standard.&nbsp;</span></div><div><br></div><div><b style="font-size: 16px">You Will:</b></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Oversee and monitor all inbound and outbound EDI transfers within our claims management system including claims, eligibility, and financial transactions.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Support the day-to-day operations of EDI including identifying and resolving technical issues.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Manage EDI projects and ensure compliance with technical standards and requirements.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Analyze business needs and design and implement efficient data exchanges internally and with external vendors and partners.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Lead innovation by improving processes and procedures to ensure compliance with regulatory requirements including HIPAA standards for PHI protection and transmission.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Collaborate with cross-functional teams to support operations and organizational needs.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.</span></div><div><br></div><div><b style="font-size: 16px">Technical Support</b></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Maintain EDI technical standards, identify integration needs, and improve the efficiency of our EDI communications and transactions.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Run/schedule/monitor EDI jobs from our claims management system, Javelina.&nbsp;</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Identify, track, &amp; ensure resolution of all technical or processing related issues across the Javelina system.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Lead the execution of the strategic initiatives to meet department and company goals.&nbsp;</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Work with the Claims Team to resolve technical issues and/or system constraints ensuring claim flow in accordance with performance KPIs.</span></div><div><br></div><div><b style="font-size: 16px">Process Improvement</b></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Identify client needs and demands and contribute to the continual improvement of the operations team.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Address deficiencies and error trends in order to resolve matters both internal and external.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Recognize and facilitate Process Improvement efforts as opportunity presents.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Work cross-departmentally to improve and streamline processes and procedures.</span></div><div><br></div><div><b style="font-size: 16px">Quality Assurance</b></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Maintain HIPAA/PII security standards to ensure data integrity across all EDI operations.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Ensure compliance with service standards.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Develop and execute plans to meet established goals.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Provide continuous feedback to strengthen and optimize quality performance.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Develop or improve current internal processes to improve overall quality.</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Identify and communicate EDI related errors to key stakeholders and assist with resolution.</span></div><div><br></div><div><b style="font-size: 16px">You Bring:</b></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Associate degree or equivalent</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Experience in processing / outsourcing services for payor or self-insured groups</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; In-depth working knowledge of ANSI X12 EDI files such as 270/271, 276/277, 834, 837, 999</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Experience in identifying/repairing/solving technical issues with EDI transactions</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Experience with SQL and relational databases</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Excellent verbal and written skills and decision-making abilities</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Able to organize, problem-solve and prioritize multiple tasks</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Positive, professional attitude</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Ability to work independently and within a team environment</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Ability to respect and maintain confidentiality and HIPAA guidelines</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Working knowledge of computer-based word processing and spreadsheet packages; proficiency with MS Office products</span></div><div><br></div><div><b style="font-size: 16px">Extra Credit:</b></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; TPA experience</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Javelina experience/administration</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Claims processing and claims payment experience</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Knowledge of medical terminology</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Improving and increasing technical knowledge through training and education&nbsp;</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Previous startup company experience</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; Previous experience having worked at or with an Electronic Clearing House</span></div><div><span style="font-size: 16px">·&nbsp; &nbsp; &nbsp; EDI certifications</span></div><div><br></div><div><br></div><div><span style="font-size: 16px">Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.</span></div>

Location: Minneapolis, MN

  

Employment Type: Full Time

  

Team: Engineering

  

Hi, we’re Gravie, and we are building the health plan of the future. For the
past few decades, the health insurance industry has evolved to serve the needs
of employers, insurance companies, brokers, and (sometimes) doctors and
hospitals. The needs of the consumer, however, have largely been left out of
the equation. We’re changing that. We are rebuilding the entire health
insurance stack, with the consumer as the central focus. Our goal is to create
a health plan that people can love.



At Gravie, you’ll get to do things every single day to support making health
benefits easy to understand and simple to navigate. You’ll work at a startup
that has demonstrated amazing growth and our future is only getting brighter.
We're past the risky early stage, but have only put a dent in the incredible
innovations to come. And you’ll join a hugely talented and passionate team.
After all, you are our competitive advantage. Our industry-changing products
and services couldn’t exist without our talented people thinking about how to
make healthcare benefits better every single day. It takes unique people on
diverse teams to deliver the kinds of results we deliver. We encourage you to
be your authentic self - we like you that way.

  

 **A Little More About The Role** :

The Claims EDI Coordinator oversees the internal production and support
process of the adjudication and reporting of medical and Rx claims. They will
work closely with other departments to proactively research concerns and
resolve issues. The person will handle EDI file management for all aspects of
the claims administration system, queries, reporting, process enhancement, and
play a key role in making sure we’re serving our clients to the Gravie
standard.

  

 **You Will:**

·      Oversee and monitor all inbound and outbound EDI transfers within our
claims management system including claims, eligibility, and financial
transactions.

·      Support the day-to-day operations of EDI including identifying and
resolving technical issues.

·      Manage EDI projects and ensure compliance with technical standards and
requirements.

·      Analyze business needs and design and implement efficient data
exchanges internally and with external vendors and partners.

·      Lead innovation by improving processes and procedures to ensure
compliance with regulatory requirements including HIPAA standards for PHI
protection and transmission.

·      Collaborate with cross-functional teams to support operations and
organizational needs.

·      Demonstrate commitment to our core competencies of being authentic,
curious, creative, empathetic and outcome oriented.

  

 **Technical Support**

·      Maintain EDI technical standards, identify integration needs, and
improve the efficiency of our EDI communications and transactions.

·      Run/schedule/monitor EDI jobs from our claims management system,
Javelina.

·      Identify, track, & ensure resolution of all technical or processing
related issues across the Javelina system.

·      Lead the execution of the strategic initiatives to meet department and
company goals.

·      Work with the Claims Team to resolve technical issues and/or system
constraints ensuring claim flow in accordance with performance KPIs.

  

 **Process Improvement**

·      Identify client needs and demands and contribute to the continual
improvement of the operations team.

·      Address deficiencies and error trends in order to resolve matters both
internal and external.

·      Recognize and facilitate Process Improvement efforts as opportunity
presents.

·      Work cross-departmentally to improve and streamline processes and
procedures.

  

 **Quality Assurance**

·      Maintain HIPAA/PII security standards to ensure data integrity across
all EDI operations.

·      Ensure compliance with service standards.

·      Develop and execute plans to meet established goals.

·      Provide continuous feedback to strengthen and optimize quality
performance.

·      Develop or improve current internal processes to improve overall
quality.

·      Identify and communicate EDI related errors to key stakeholders and
assist with resolution.

  

 **You Bring:**

·      Associate degree or equivalent

·      Experience in processing / outsourcing services for payor or self-
insured groups

·      In-depth working knowledge of ANSI X12 EDI files such as 270/271,
276/277, 834, 837, 999

·      Experience in identifying/repairing/solving technical issues with EDI
transactions

·      Experience with SQL and relational databases

·      Excellent verbal and written skills and decision-making abilities

·      Able to organize, problem-solve and prioritize multiple tasks

·      Positive, professional attitude

·      Ability to work independently and within a team environment

·      Ability to respect and maintain confidentiality and HIPAA guidelines

·      Working knowledge of computer-based word processing and spreadsheet
packages; proficiency with MS Office products

  

 **Extra Credit:**

·      TPA experience

·      Javelina experience/administration

·      Claims processing and claims payment experience

·      Knowledge of medical terminology

·      Improving and increasing technical knowledge through training and
education

·      Previous startup company experience

·      Previous experience having worked at or with an Electronic Clearing
House

·      EDI certifications

  

  

Competitive pay is standard. Our unique benefits program is the gravy, i.e.,
the special sauce that sets our compensation package apart. In addition to
standard benefits, Gravie’s package includes alternative medicine coverage,
flexible PTO, up to 16 weeks paid parental leave, paid holidays, cell phone
reimbursement, education reimbursement, and 1 week of paid paw-ternity leave
just to name a few.

