Manager - Payer Operations

Job description

Company Description

Experian is a global data and technology company, powering opportunities for people and businesses around the world. We help to redefine lending practices, uncover and prevent fraud, simplify healthcare, create digital marketing solutions, and gain deeper insights into the automotive market, all using our unique combination of data, analytics and software. We also assist millions of people to realise their financial goals and help them to save time and money.

We operate across a range of markets, from financial services to healthcare, automotive, agrifinance, insurance, and many more industry segments.

We invest in people and new advanced technologies to unlock the power of data and to innovate. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), we have a team of 23,300 people across 32 countries. Our corporate headquarters are in Dublin, Ireland. Learn more at experianplc.com.

Job Description

Reporting to Experian Health, the Manager – Payer Operations will lead a team of EDI Analysts responsible for optimizing connectivity monitoring and ensuring operational excellence across electronic transaction workflows. The Manager will be an important escalation point, guide process improvements, and collaborate with all partners to ensure seamless payer integration and performance.

You will:

• Lead a team of EDI Analysts (Levels 1–3) assuring optimal performance and providing coaching for professional development.
• Oversee daily operations related to payer transaction monitoring, and issue resolution.
• Ensure identification, escalation, and resolution of EDI transaction errors and connectivity issues.
• Coordinate with external trading partners and company partners to resolve issues
• Guide the development of EDI documentation and process documentation.
• Help implement automation and AI technologies to improve operational efficiency.
• Monitor team workload and performance metrics, ensuring adherence to performance and service level expectations.
• Implement process improvements, including documentation standards, tooling enhancements, and cross-training plans.
• Represent the team in meetings and industry forums.
• Maintain an understanding of healthcare EDI standards (²⁷⁰⁄₂₇₁, ⁸³⁵⁄₈₃₇, 278, 275) and evolving industry requirements.

Qualifications

Education & Experience:·

• Bachelor’s degree in business, Computer Science, Healthcare Administration, or related field
• 5+ years of experience in healthcare EDI, payer operations, or revenue cycle management required
• 2+ years of direct people management experience overseeing technical or operational teams required
• Knowledge of X12 and HL7 transactions, including 27x, 83x, and 278.
• Familiarity with payer/provider enrollment processes, EDI protocols, and API/web capture methods.
• Proficiency in Salesforce, JIRA, Microsoft 365, and data analytics tools (especially Excel).
• Experience with Agile methodologies (Scrum, Kanban)

Additional Information

Benefits/Perks:

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays
• Explore all our exciting benefits here: https://yourexperianbenefits.com/cand-index.html

Our uniqueness is that we celebrate yours. Experian’s culture and people are important differentiators. We take our people agenda very seriously and focus on what matters; DEI, work/life balance, development, authenticity, collaboration, wellness, reward & recognition, volunteering… the list goes on. Experian’s people first approach is award-winning; World’s Best Workplaces™ 2024 (Fortune Top 25), Great Place To Work™ in 24 countries, and Glassdoor Best Places to Work 2024 to name a few. Check out Experian Life on social or our Careers Site to understand why.

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. You will be also eligible for a variable pay opportunity.

Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. Innovation is an important part of Experian’s DNA and practices, and our inclusive workforce allows everyone to succeed and bring their whole self to work. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.

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