Senior Application Support Analyst (Claims/EDI Focused)

Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building.

Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare’s greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.

Overview: The Sr. Application Support Analyst will be responsible for working cross-functionally to research and resolve issues related to deliver of claim processing business rules, errors and related activity. This will include working closely with Technical Support and Engineering teams on complex issues. In this role, the right individual will have the opportunity to work with the team that supports and delivers complex and automated business rules routines to assist in revenue cycle automation. These functions required inbound task review, requirements gathering, testing/QA and project management activities.

 

Duties and Responsibilities:

• Work directly with customers to understand and implement custom billing rules;
• Work with Technical Services and Engineering to research and implement product updates and enhancements;
• Address requests in priority order and track through to resolution;
• Identify and suggest necessary solutions or process changes to improve efficiency;
• Contribute to product improvements by sharing ideas and feedback to product development;
• Troubleshoot and coordinate code changes required due to defects or payer changes;
• Document any changes to the connectivity with the trading partners;
• Supporting other department team members ‘real time’ as they work with clients;
• Review correspondence from trading partners and healthcare payers that may impact Inovalon processes and customers;
• Perform all research needed to account for revenue cycle automation activities;
• Other duties/projects as assigned;
• Maintain compliance with Inovalon’s policies, procedures and mission statement;
• Adhere to all confidentiality and HIPAA requirements;
• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Employer.

 

Job Requirements:

• Minimum of 2 years of experience in Healthcare IT industry (medical billing, IT, MAC or other payer) required;
• Detailed understanding of ANSI X12 transactions including 270/271, 276, 278, 820, 835, and 837 transactions;
• Experience in a customer service-related role with high healthcare transactions;
• Conceptual understanding of healthcare Electronic Data Interchange (EDI);
• Proficient in ServiceNow, Salesforce or other CRM system;
• Excellent communication skills are essential. Must be able to give and receive correct information, explain difficult information, and maintain a customer service attitude to all levels of users;
• The ability to work efficiently in a fast-paced, high-volume environment;
• Excellent customer service skills such as developed phone skills, customer relationship management, multi-tasking etc.;
• Strong problem solving/analytical skills, detail oriented ;
• Self-motivated with strong organizational/prioritization skills and ability to multi-task with close attention to detail;
• Must be able to organize and manage workload efficiently and prioritize projects with minimal supervision;
• Strong interpersonal skills, including customer relationship skills in conjunction with the ability to work well in a team environment as well as to work independently and assume responsibility; and
• Strong organization skills and an ability to multitask to meet multiple deadlines in short time frames.

 

Education:

• Bachelor's degree or equivalent work experience required.

 

Physical Demands and Work Environment:

• Sedentary work (i.e. sitting for long periods of time);
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force;
• Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions;
• Subject to inside environmental conditions; and
• Travel for this position will include less than 5% locally usually for training purposes.

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