EDI Implementation Analyst II

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change.

At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission.

We're on a mission to bring the focus back to what truly matters – patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 13 billion transactions annually, our influence is continually expanding.

Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem.

Reporting to the Manager, Health Plan Implementation Analysts, the EDI Implementation Analyst II role is technical in nature and requires a strong understanding of the interaction between the Availity systems and Availity customers, primarily from a receiver perspective. The EDI Implementation Analyst II role focuses on moderate to complex implementation tasks and responsibilities. The role is accountable for assessing, analyzing, and implementing solutions in a timely and efficient manner.

Key responsibilities include, but are not limited to a) managing internal and external relationships with payers and vendors to meet integration objectives set by Program Management; b) creating appropriate documented deliverables, managing deliverables, gaining agreement from internal and external partners; and c) coordinating partner awareness on Availity functionality as requested by Program Management and production issues as requested by internal teams, including but not limited to Operations support team and/or Information Technology team.

Sponsorship, in any form, is not available for this position.

Location: Remote, US

To be qualified for the role, you have:

Bachelor’s degree or the equivalent work experience

4+ years of related experience in a technology (information exchange) and/or healthcare environment

4+ years of experience with managing simple to moderately complex implementations and delivering results with speed, accountability, and trust

Knowledge of the health care industry specifically claims processing systems, provider office operations, and customer service processes in a health care company

Understanding of HIPAA implementation guides for claim and other transactions

Knowledge of the health care industry HIPAA mandated ANSI transaction formats.

Must have a working knowledge of X12 transactions specifically 837P, 837I, 835, 270/271, 276/277, 278, CCR/CCD

Ability to create and execute test plans

Ability to create documentation such as training resources and reference materials

Ability to establish and maintain effective working relationships, supporting internal and external partners

Excellent written and verbal communication skills including strong presentation skills and the ability to present executive summaries in a concise manner

Ability to effectively manage multiple priorities in a fast-paced environment

Flexibility and ability to embrace change

Ability to prepare documented customer requirements

Experience with Submitters, Vendors and/or Receivers/Payers is a plus

Customer service and/or relationship management experience is a plus

Experience in software implementations is a plus

What you will be doing:

Solutions Integration

Implementation Planning:

Accountable for all complexity level implementations, including but not limited to submitters, partners, and vendors; to exchange all transaction types through methods such as EDI, B2B, web transactions, API, and others as defined implementations. Tasks involve managing client timelines and deliverables, issue resolution, file transmission, response reporting, testing and results delivery based on customer requirements using Availity processes and tools

Acts under the guidance of the Level III EDI Implementation Analysts

Will be responsible for Analyst level tasks of all implementations. Including, but not limited to, developing the implementation plan for all new implementation requests (direct receiver/payer, and partner and vendor), initiating implementation plan with customer, creating all tickets required to execute implementation plan completely.

Implementation Tracking and Execution:

Manages multiple moderate to complex implementations, including timelines, issue resolution and results delivery using Availity standard tools and processes

Assesses and analyzes moderately complex standard and non-standard implementations, including HIPAA rules and Availity standards and options and follows processes accordingly

In partnership with external and internal stakeholders, the EDI Implementation Analyst II conducts pre-production functional testing protocols, including creating and executing test plans for the implementation

Tracks progress of specific implementation projects via Availity tools including JIRA, Confluence and Salesforce

​Resource Coordination:

Mentors EDI Implementation Analysts to ensure projects are completed on a timely basis and ensures Availity standards are followed.

Interacts with Payer/Trading Partner, Vendor and Provider Marketing, Business Development, Business Technology Solutions, Product Management, Finance, and Operations

Communication and coordination between all Availity platforms- (HEW, Patient Access, RCM)

The EDI Implementation Analyst II will be engaged in providing estimates of work for implementations for submitters, partners and vendors when required.

The EDI Implementation Analyst II is responsible for managing the workflow of moderate to complex implementations and any other responsibilities of the EDI Implementation Analyst II and ensuring all commitments are maintained.

Customer Relationship Management:

Interacts with business, technical, internal and external resources on new and existing implementation solutions and partners. The EDI Implementation Analyst II will be required to represent the company in a professional manner to external customers with supervision as needed.

Assists the Channels Sales, Account Management, and Payer Solutions staff in finalizing opportunities by providing technical guidance to external stakeholders.

Ensures market validation (utilization) of solution by driving clean hand off to account management or operational support teams.

Communicates new implementations and all related changes including detailed specifications

Monitors customer communications (submitter, payer, trading partners, etc) to be apprised of any changes that may impact business operations (new edits, connectivity updates, system downtime)

Interacts closely with other technology teams and development staff to ensure requirements able to be met accurately and executed within the expected timeline for the implementations.

Operations Support

Process Documentation and Improvement:

Leads in the development of Availity support documentation (such as production issues, impact and solutions as it relates to the responsibilities of the EDI Implementation Analyst II).

Documents moderately complex standard processes (such as standard testing procedures) as necessary for continuous process improvement

Responsible for documenting all information related to assig