Healthcare Claims EDI Manager
About Health Payer Consortium (HPC)We're a high-growth healthcare company that cares about and takes care of our employees. We have been doubling in size nearly every year for a decade. We have a work-hard, play-hard culture. Whether we're jamming at a show, hitting the Derby, or just hanging at the office, you'll find a team of top performers who know how to have fun, support each other, and get results.Position OverviewThe Healthcare Claims EDI Manager will oversee multiple EDI-related projects simultaneously and a team of three, ensuring timely delivery, quality, and alignment with business objectives. This role requires strong organizational skills, the ability to manage competing priorities, and a proven track record of driving projects to successful completion. You'll collaborate with cross-functional teams, communicate with stakeholders, and help HPC continue to innovate in the healthcare space.Key ResponsibilitiesManage several EDI projects concurrently from initiation to completionCoordinate the HPC EDI team (currently three members)Develop project plans, timelines, and deliverables for each initiativeCoordinate with internal teams, vendors, and stakeholders to ensure project goals are metMonitor project progress, identify risks, and implement mitigation strategiesCommunicate status updates and project outcomes to leadership and stakeholdersEnsure all projects are delivered on time, within scope, and within budgetSupport a collaborative, high-energy office culture and participate in company eventsRequired QualificationsCertified Health Claims EDI Specialist designation5+ years experience in healthcare EDI with a technical understanding of healthcare EDI operations: receiving and transmitting 837 files; monitoring all EDI inventory and ensuring timely processing and return of claimsQuality assurance experience trouble shooting claims flow issuesProven ability to manage multiple large-scale projects simultaneouslyProven ability to manage people towards a common goalStrong analytical, organizational and time management skillsExcellent written and verbal communication skillsProficiency with project management tools (and MS Office Suite - especially Excel and PowerPoint)Ability to work effectively in a fast-paced, team-oriented, in-office environmentPreferred Qualifications2+ years of Project Management experience (PMP certification and experience with Monday.com are both bonuses)Experience with healthcare EDI x12 transactions and healthcare claimsMedical coding certification (CPC, CCS, etc.)Experience reviewing provider claims for technical errorsFamiliarity with claims editing software/rules (unbundling, DRG, appeals)Familiarity with healthcare compliance and data security requirementsExperience with a cost containment companyExtra Bonus if you have a music background, play an instrument or just LOVE live musicSchedule & Work EnvironmentFull-time, Monday–Friday, 8:00 am–5:00 pmOccasional travel to company functions and industry conferencesAdditional hours as needed based on project deadlines100% in-office (no remote work)Candidates must currently reside within daily commuting distance of Maryland Heights, MO 63146. Only local candidates will be considered.Perks & BenefitsCompetitive salary (based on experience)Full benefits package401(k) with company matchPTO, paid holidays, and moreIf you prefer to work through your lunch break, we'll provide lunch for you each dayMentorship ProgramAdvancement and training opportunitiesAn amazing team that loves to celebrate winsThis is a 100% in-office position. Remote work is not available.Ready to join a team where your skills matter and your personality shines?