Company Description

EMI Health is a nonprofit organization, which was founded by teachers in 1935. During the subsequent 80 plus years, we have evolved into a successful full-service health insurance organization serving employer groups in both public and commercial sectors.

Our mission statement at EMI Health is a symbol of what EMI stands for. It is a promise to our members and to you. It carries the promise that we, as employees, will always put the member first in the decisions we make and in the kind of service and assistance we provide. It also carries the promise that, as an employee of EMI Health, you are part of a team that together sets and achieves goals and continues to grow together and individually.

Our Offering

We’re looking for positive, passionate, goal-driven people who thrive in a fast-paced environment. We offer a stable, long-term employment situation with competitive salary and loads of benefits, including paid time off, insurance (medical, dental, life and disability), 401k, and more. We're a really fun team and currently experiencing rapid growth. We're proud winners of numerous awards including Best of State in insurance.

Job Description

The IT Operations position is responsible for verifying system processes as well as movement of EDI data in a medical insurance production environment. This position will also be involved in translation development, scripting and automation of daily files, resolving communications and data translation errors. This position will work in verifying and manipulating medical EDI files to comply with rules and regulations.

This is a full-time position. Hours are generally 8:00 a.m. to 5:00 p.m. Monday through Friday.

Responsibilities

The IT Operations position will provide support for the insurance claims processing system, including running jobs and verifying the completion of processes. Included in these processes is the movement and processing of medical insurance claims EDI files. They will also assist with the EDI enrollment process which includes working with trading partners, analyzing enrollment data, testing and resolving any data load issues. They work with employees at all levels of the organization to support accurate data exchanges. This position typically is full time and takes place in an office setting (partial remote work is available after trial period).

• Manage and execute applied standards for insurance claims processing system.
• Test, implement and maintain system and EDI transactions.
• Provides technical expertise and support for system and EDI communications.
• Other duties may be assigned.

Requirements

The IT Operations position requires a bachelor’s degree in a relevant discipline and/or experience working with Information systems and EDI technologies in the industry. Excellent interpersonal and multitasking skills are required. Good analytical skills and the ability to easily read and understand complex documents and procedures are necessary as well.

• Advanced communication skills, both written and verbal, with precision in grammar.
• Ability to read and comprehend instructions, correspondence, and reports.
• Ability to effectively present information in one-on-one and group situations to customers, clients and employees of the organization.
• Ability to effectively present information to top management.
• Advanced computer skills including Microsoft Office, Outlook, and Windows. Experience with a file management system, such as GoAnywhere is a plus.
• Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
• Knowledge of all X12 health care claim formats.
• An understanding of enrollment procedures and health benefit plans is required.
• Understanding of health care claims and process flow is beneficial.