Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centric health benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.
A Little More About Us:
· We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.
· We are quickly becoming one of the fastest growing health benefits companies in the country. We have received numerous awards and accolades, including Inc. Magazine Best in Business Gold Medal award in 2021, and JMP Securities Top 50 Private Companies in Insurtech in 2022.
· We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.
· Our customers like us. Our revenue churn is in the low single digits, in an industry where greater than 20% churn is common.
· Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve. We may not be the right place for everybody, but if you get energized by doing work every day that focuses on putting consumers at the front of the line, we could be a great place for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.
A Little More About The Role:
The Claims EDI Coordinator oversees the internal production and support process of the adjudication and reporting of medical and Rx claims. They will work closely with other departments to proactively research concerns and resolve issues. The person will handle EDI file management for all aspects of the claims administration system, queries, reporting, process enhancement, and play a key role in making sure we’re serving our clients to the Gravie standard.
You will:
· Oversee and monitor all inbound and outbound EDI transfers within our claims management system including claims, eligibility, and financial transactions.
· Support the day-to-day operations of EDI including identifying and resolving technical issues.
· Run/schedule/monitor EDI jobs from our claims management system, Javelina.
· Analyze business needs and design and implement efficient data exchanges internally and with external vendors and partners.
· Recognize and facilitate Process Improvement efforts as opportunity presents.
· Lead innovation by improving processes and procedures to ensure compliance with regulatory requirements including HIPAA standards for PHI protection and transmission.
· Collaborate with cross-functional teams to support operations and organizational needs.
· Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.
You bring:
· An associate’s degree or equivalent work experience.
· Experience in processing / outsourcing services for payor or self-insured groups.
· In-depth working knowledge of ANSI X12 EDI files such as 270/271, 276/277, 834, 837, 999.
· Experience in identifying/repairing/solving technical issues with EDI transactions.
· Experience with SQL and relational databases.
· Excellent verbal and written skills and decision-making abilities.
· Able to organize, problem-solve and prioritize multiple tasks.
· Positive, professional attitude
· Ability to work independently and within a team environment.
· Ability to respect and maintain confidentiality and HIPAA guidelines.
· Working knowledge of computer-based word processing and spreadsheet packages; proficiency with MS Office products
Extra credit:
· TPA experience
· Javelina experience/administration
· Claims processing and claims payment experience
· Knowledge of medical terminology
· Previous startup company experience
· Previous experience having worked at or with an Electronic Clearing House
· EDI certifications
Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.
