Job Description

Job Description

About Health Payer Consortium (HPC)

We’re a high-growth healthcare company that cares about and takes care of our employees. We have been doubling in size nearly every year for a decade. We have a work-hard, play-hard culture. Whether we’re jamming at a show, hitting the Derby, or just hanging at the office, you’ll find a team of top performers who know how to have fun, support each other, and get results.

Position Overview

The Healthcare Claims EDI Manager will oversee multiple EDI-related projects simultaneously and a team of three, ensuring timely delivery, quality, and alignment with business objectives. This role requires strong organizational skills, the ability to manage competing priorities, and a proven track record of driving projects to successful completion. You’ll collaborate with cross-functional teams, communicate with stakeholders, and help HPC continue to innovate in the healthcare space.

Key Responsibilities

• Manage several EDI projects concurrently from initiation to completion
• Coordinate the HPC EDI team (currently three members)
• Develop project plans, timelines, and deliverables for each initiative
• Coordinate with internal teams, vendors, and stakeholders to ensure project goals are met
• Monitor project progress, identify risks, and implement mitigation strategies
• Communicate status updates and project outcomes to leadership and stakeholders
• Ensure all projects are delivered on time, within scope, and within budget
• Support a collaborative, high-energy office culture and participate in company events

Required Qualifications

• Certified Health Claims EDI Specialist designation
• 5+ years experience in healthcare EDI with a technical understanding of healthcare EDI operations: receiving and transmitting 837 files; monitoring all EDI inventory and ensuring timely processing and return of claims
• Quality assurance experience trouble shooting claims flow issues
• Proven ability to manage multiple large-scale projects simultaneously
• Proven ability to manage people towards a common goal
• Strong analytical, organizational and time management skills
• Excellent written and verbal communication skills
• Proficiency with project management tools (and MS Office Suite - especially Excel and PowerPoint)
• Ability to work effectively in a fast-paced, team-oriented, in-office environment

Preferred Qualifications

• 2+ years of Project Management experience (PMP certification and experience with Monday.com are both bonuses)
• Experience with healthcare EDI x12 transactions and healthcare claims
• Medical coding certification (CPC, CCS, etc.)
• Experience reviewing provider claims for technical errors
• Familiarity with claims editing software/rules (unbundling, DRG, appeals)
• Familiarity with healthcare compliance and data security requirements
• Experience with a cost containment company
• Extra Bonus if you have a music background, play an instrument or just LOVE live music

Schedule & Work Environment

• Full-time, Monday–Friday, 8:00 am–5:00 pm
• Occasional travel to company functions and industry conferences
• Additional hours as needed based on project deadlines
• 100% in-office (no remote work)
• Candidates must currently reside within daily commuting distance of Maryland Heights, MO 63146. Only local candidates will be considered.

Perks & Benefits

• Competitive salary (based on experience)
• Full benefits package
• 401(k) with company match
• PTO, paid holidays, and more
• If you prefer to work through your lunch break, we’ll provide lunch for you each day
• Mentorship Program
• Advancement and training opportunities
• An amazing team that loves to celebrate wins

This is a 100% in-office position. Remote work is not available.

Ready to join a team where your skills matter and your personality shines?

Job Tags

Similar Jobs