EDI Complex Issue Resolution Associate
Massachusetts
- Healthcare
- Full-time
- EDI 837
- Healthcare IT
- Revenue Cycle Management
The EDI Complex Issue Resolution Associate supports and configures EDI components and workflows for electronic healthcare claims within the IDX revenue cycle system. This role involves advanced technical support, custom software development, customer onboarding, training, troubleshooting, and managing EDI solutions to ensure regulatory compliance and optimal system performance. Collaboration with customers and internal teams is essential to deliver best practice EDI workflows and maintain integrated healthcare IT environments.
Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
The EDI Complex Issue Resolution Associate is an EDI engineer working with clients to configure and support the EDI components, integrations and workflows for Electronic Claims (EDI837) in the IDX revenue cycle system. The EDI Engineer will provide advanced technical support for customer business requirements. Solutions will be complex and technical in nature and consist of advanced system configuration options and custom software development incorporating best practice workflow. Solutions will be designed, written, tested and managed from test to production environments to maintain system integrity. While dedicated to EDI workflows in the aIDX revenue cycle systems, the engineer must consider full IDX integration for robust best practice solutions and customer workflows. The EDI Engineer will have dedicated customer assignments for Onboarding, either new to IDX or new to EDI solutions, and/or perform work in Support to assist customers live on EDI solutions.
Essential Functions (Duties and Responsibilities):
EDI837 Claims includes, and may not be limited to, professional medical, dental, ambulatory surgical and inpatient claim capabilities in the IDX PM system, BAR and HPA. Implementation and support of paper claims may also be included.
Understand customer workflow and billing requirements and translate this into EDI configuration and workflow.
Work closely with customers in the onboarding phase to design and configure claim workflows. This includes training customers on EDI/IDX best practice workflows and managing projects to scope in design, effort, timelines and budget.
Resolve customer support cases, including intake, research, troubleshooting, resolution, training and comprehensive technical documentation.
Troubleshooting claim workflows reported by customers.
Produce clear and precise technical design specifications at the appropriate detail level.
Adhere to coding conventions, architectures, and best practices.
Write, debug, and deploy code to production, delivering timely fixes.
Deploy and support new features, including software upgrades and compliance with regulatory requirements and payer mandates.
Cultivate and sustain trusting relationships with customers to foster collaborative partnerships.
Provide thorough training to customers on the best practice use of EDI claim features and workflows.
Interface with customers via phone, meetings, and through customer support cases.
Thoroughly document solutions in applicable systems.
Exhibit strong customer management skills, clearly communicating expectations, deliverables, next steps, and commitments.
Effectively manage multiple customer projects simultaneously across onboarding and support.
Collaboration and support of internal teams is critical to success.
Education & Experience Required:
Bachelor’s degree in a related field or equivalent experience
2 to 4 years of software product implementation or support in a Healthcare IT or Healthcare Operations environment
2 to 4 years of experience with Revenue Cycle Management
2 to 4 years of experience with implementing or supporting EDI 837, 835, 270/271 or 276/277
2 to 4 years preferred experience with athenaIDX based applications,
2 to 4 years preferred experience with MUMPS/Caché programming
Knowledge & Skills:
Analytical thinking and systematic approach to issue troubleshooting
Demonstrated ability to work independently and collaboratively with assigned teams
Demonstrated experience working directly with customers
Ability to write code that is technically sound, performant, scalable, and readable
Ability to multi-task and balance competing priorities
A strong desire to learn new skills and be flexible with job duties including being cross trained on various applications and responsibilities
Demonstrate resourcefulness by conducting thorough research while recognizing limits and proactively seeking assistance when necessary
Strong communication skills, both verbal and written
Highly detail-oriented and a strong work ethic
Expected Compensation
$78,000 - $132,000The base salary range shown reflects the full range for this role from minimum to maximum. At athenahealth, base pay depends on multiple factors, including job-related experience, relevant knowledge and skills, how your qualifications compare to others in similar roles, and geographical market rates. Base pay is only one part of our competitive Total Rewards package - depending on role eligibility, we offer both short and long-term incentives by way of an annual discretionary bonus plan, variable compensation plan, and equity plans.
About athenahealth
Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
Our company culture: Our talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.
Our DEI commitment: Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers and the communities where we work and serve.
What we can do for you:
Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.
We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.
In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. We provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.
Learn more about our culture and benefits here: athenahealth.com/careers
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