Top 611651 Manager Claims Management Jobs

Healthcare Claims EDI Manager
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- Microsoft Excel
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Quick Apply
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Healthcare Claims EDI Manager

Health Payer Consortium
St. Louis, MO

Quick Apply

Job Details

Full-time

Benefits

Paid holidays
Relocation assistance
Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Project manager experience
Healthcare compliance analytics tools
Microsoft Excel
EDI
Medical Coding Certification
Medical claims processing software
Quality assurance
Team management
Quality issues
Project management experience in healthcare
Leading team collaboration initiatives
Project management software
Managing projects
Productivity software
Technical Proficiency

Full Job Description

Healthcare Claims EDI Manager

Location: St. Louis, MO (Westport) | 100% In-Office

Hours: Monday–Friday, 8:00am–5:00pm

Pay: Salary - Based on experience - We pay above current market value

Benefits: 401(k) + Match, Medical, Dental, Vision, FSA, PTO, Life Insurance

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 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
Remote work considered for the right candidate

Perks & Benefits

Salary (DOE) we pay above current market value - If you have the skillset we are looking for - Apply!
Full benefits package (see above)
401(k) with company match
PTO, paid holidays, and more
Mentorship Program
Advancement and training opportunities
An amazing team that loves to celebrate wins

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

Job Type: Full-time

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Relocation assistance
Tuition reimbursement
Vision insurance

Experience:

Healthcare EDI: 5 years (Required)

License/Certification:

Certified Health Claims EDI Specialist Designation (Required)

Work Location: Hybrid remote in St. Louis, MO 63146

Quick Apply

Refine Your Search

Manager Claims Management jobs

Healthcare Claims EDI Manager

Management Adjusting CSL Associate Manager

Processing Manager

Senior Credit and Collections Manager

Sr. Manager, Consulting - Asset Management & Investment

Internal Audit Manager (Remote)

CAT Claims Manager

Payments Implementation Manager

Manager, Consulting - Asset & Investment Management

Sr. Manager, Credit Risk Analytics - Credit Card

Senior Accounting Manager

Tax Manager

Electrical Service Manager

Credit and Collections Manager

Tax Manager

Accounting Manager

Investor Relations Manager

Branch Manager 2

Manager, Actuarial

Data & IT Manager

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