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Senior Rules and Format Associate

78% Flex
EXTRA HOLIDAYS - EXTRA PARENTAL LEAVE
Remote: 
Full Remote
Experience: 
Mid-level (2-5 years)
Work from: 

Offer summary

Qualifications:

Bachelor’s Degree or equivalent experience, 1-3 years IT support in healthcare, Knowledge of medical claims and coding, Experience with claim scrubbing engines, Ability to lead cross-functional projects.

Key responsabilities:

  • Analyze data to solve problems
  • Design solutions for operational efficiency
  • Lead projects and influence stakeholders
  • Improve customer value through service enhancement
  • Identify opportunities for optimization
Athenahealth logo
Athenahealth XLarge http://www.athenahealth.com/
5001 - 10000 Employees
See more Athenahealth offers

Job description

Logo Jobgether

Your missions

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Senior Rules and Format Associate

The Senior Rules and Format Associate will be responsible for the delivery and ongoing support of business solutions for the athenaEDI organization. Your mission will be to develop and implement solutions to improve customer value and athena operational efficiency. To succeed, you are a strong analytical problem solver and an excellent communicator who is committed to achieving positive outcomes for customers and our business. The Senior Associate is a critical thinker who leads complex projects, influences stakeholders, and demonstrates command of both technical and industry knowledge.

Job Responsibilities

  • Use both hard data analysis and qualitative evaluation to determine root causes of a problem

  • Leverage knowledge of medical claims, coding, and insurance payers to design and support robust solutions that favor automation and work efficiency over manual workflows

  • Master workflow design and analysis considering impact on dependent processes and ensuring continuity of work delivery

  • Identify opportunities to expand the value we provide to clients through more and/or better service(s) using your understanding of athena solutions and customer business problems

  • Contribute to initiatives and lead projects that optimize our customers’ use of athena claim scrubbing capabilities and improves their overall financial performance

  • Create and curate project plans, bal ancing stakeholder expectations, opportunity and risk

  • Ensure success by leading execution across the company - including commercial, R&D, and operations

  • Present project purpose, updates, and outcomes to athenaEDI leadership, demonstrating command over all components of the project

  • Discover customer requirements and improve the service by incorporating feedback into product and service prioritization

Typical Qualifications

  • Bachelor’s Degree (or commensurate level of professional experience)

  • 1-3 years of customer service experience in IT Support in a healthcare related business

  • 1-3 years of experience with Optum Claims Manager or similar rule-based claim scrubbing engine (or demonstrated aptitude based on prior EDI claims experience)

  • Experience working with cross-functional groups and teams to achieve common goals and communicating and presenting to stakeholders

  • Demonstrated ability to assume sole and independent responsibility for various customer facing and internal projects

  • Knowledge of Healthcare billing workflows, claim coding, a Certified Professional Coder preferred

For candidates located in California, Colorado, Hawaii, Jersey City (NJ), New York City, Westchester County (NY), and Washington, please visit the following link for pay range information:

California: https://www.athenahealth.com/salary-range/ca-nontech-sr-associate

Colorado: https://www.athenahealth.com/salary-range/co-nontech-sr-associate

Hawaii: https://www.athenahealth.com/salary-range/hi-nontech-sr-associate

New Jersey: https://www.athenahealth.com/salary-range/nj-nontech-sr-associate

New York: https://www.athenahealth.com/salary-range/ny-nontech-sr-associate

Washington: https://www.athenahealth.com/salary-range/wa-nontech-sr-associate

About athenahealth

Here’s our vision: To create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. 

What’s unique about our locations? 
From an historic, 19th century arsenal to a converted, landmark power plant, all of athenahealth’s offices were carefully chosen to represent our innovative spirit and promote the most positive and productive work environment for our teams. Our 10 offices across the United States and India — plus numerous remote employees — all work to modernize the healthcare experience, together. 
 
Our company culture might be our best feature. 
We don't take ourselves too seriously. But our work? That’s another story. athenahealth develops and implements products and services that support US healthcare: It’s our chance to create healthier futures for ourselves, for our family and friends, for everyone.  

 

Our vibrant and talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our goal. We continue to expand our workforce with amazing people who bring diverse backgrounds, experiences, and perspectives at every level, and foster an environment where every athenista feels comfortable bringing their best selves to work. 

 

Our size makes a difference, too: We are small enough that your individual contributions will stand out — but large enough to grow your career with our resources and established business stability. 
 
Giving back is integral to our culture. Our athenaGives platform strives to support food security, expand access to high-quality healthcare for all, and support STEM education to develop providers and technologists who will provide access to high-quality healthcare for all in the future. As part of the evolution of athenahealth’s Corporate Social Responsibility (CSR) program, we’ve selected nonprofit partners that align with our purpose and let us foster long-term partnerships for charitable giving, employee volunteerism, insight sharing, collaboration, and cross-team engagement. 

 

What can we do for you? 
Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.  

 

In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. And we provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued 

 

We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation. 

athenahealth is committed to a policy of equal employment opportunity—that’s why we recruit and hire applicants without regard to race, color, religion, sex (including pregnancy), national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. We’re happy to provide a reasonable accommodation, for those with a disability, to complete any part of the application process. If you are unable to access or use this online application process and need an alternative method for applying, please contact us at taoperations@athenahealth.com for assistance.

https://www.athenahealth.com/careers/equal-opportunity

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Soft Skills

  • Customer Service
  • Analytical Thinking
  • Interpersonal Skills
  • Leadership
  • Problem Solving
  • Stakeholder Management

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