Claims Integration Manager

Responsibilities

Role Overview :

We are seeking an experienced and driven EDI Integration Lead to oversee product requirements and delivery for claims integrations and file processing, particularly around EDI transactions (837, 835). This role is pivotal in bridging technical, product, and client delivery teams to support mission-critical activities, including legacy system integrations, client onboarding, and strategic platform enhancements.

Key Responsibilities :

• Own and manage the product backlog and requirements related to EDI claims integrations and file processes (837, 835).
• Collaborate with cross-functional teams including engineering, product owners, and client delivery to prioritize and deliver key initiatives.
• Support ongoing platform operations including bug fixes, enhancements, and new client implementations.
• Partner with :
• Red Team for legacy claims systems (e.G., Impact).
• Yellow Team for forward-looking initiatives such as centralized integrations and web portal development.
• Lead requirement gathering, write epics and user stories, and drive agile practices across projects.
• Engage directly with stakeholders to ensure high-priority deliverables are met on time and to specification.
• Serve as a subject matter expert (SME) on claims adjudication processes and payer workflows.

Required Qualifications :

Preferred Qualifications :

Why Join Us :