Senior Payer Gateway Lead - EDI & Claims Operations
Judi Health, LLC
Judi Health, LLC in New York is seeking a Senior Lead Payer Gateway Manager to oversee HIPAA EDI transactions and hosted gateway solutions across payers, providers, and TPAs. You will ensure timely submissions, validation, and reconciliation to support accurate adjudication and reduce processing delays. The role requires strong EDI knowledge, ability to translate technical issues for cross-functional teams, and leadership to drive continuous improvement in gateway performance and compliance. #J-18808-Ljbffr Judi Health, LLC
$174.8k - $218.5k
...industry's first Unified Claims Processing™... ...achieve unprecedented operational efficiency and service... ...Americans and proudly leading the next generation of... ...Position Summary The Senior Lead Payer Gateway Management oversees electronic... ...processing of HIPAA EDI transactions and...OperationsEDISeniorClaimsLocal areaFlexible hours- ...services company with leading capabilities in digital... ...Interactive, Technology and Operations services—all powered by... ...: An experienced Epic Payer Platform Lead who has... ...certification in Claims, E&E, Benefits Engine,... ...integration standards (FHIR R4, EDI X12, CDA/CCDA) as...OperationsEDIClaimsFull timeWork experience placementLive inWork at officeLocal area
$180k - $200k
...Senior Data Engineer (Claims) Job type: Full Time · Department: EPD · Work type: Hybrid... ...is a new kind of claims operations partner for health plans.... ...healthcare data, particularly: Payer claims, eligibility/... ...files, and remittances (e.g., EDI 837/835). Understanding of...OperationsEDISeniorClaimsFull timeVisa sponsorshipWork visa$170k - $190k
Senior Analytics Engineer Job type: Full Time · Department... ...is a new kind of claims operations partner for health plans... ...for someone who will lead the charge to build the... ...requirements. Prior work at a payer, health tech company,... ...vendor. Exposure to EDI formats (e.g., X12 837/...OperationsEDISeniorClaimsFull timeVisa sponsorshipWork visa- Imagine360 is seeking a Senior Operations Specialist to join the team!... ...professional with deep expertise in EDI (Electronic Data... ...HIPAA 834 Enrollment and 837 Claims transactions, to lead implementation efforts and... ...platforms. Knowledge of payer systems, claims...OperationsEDISeniorClaimsTemporary workRemote work
$170k - $240k
...Commure, we're building the AI Operating System for healthcare, the... ...autonomous RCM processing billions in claims, all on a single AI-native... ...encounter into a clean, payer‑accepted claim. What You’ll Do... ...payloads into valid electronic EDI claims across professional (CMS...OperationsEDISeniorClaimsImmediate start- Hunter Douglas, Inc. seeks a Senior ERP Analyst to lead SAP S/4HANA OTC design, implementation, and support... ...efficient, accurate order-to-cash operations and customer satisfaction. The role requires... ...expertise with IDocs, middleware, EDI, and APIs. #J-18808-Ljbffr Hunter...OperationsEDISenior
- Judi Health is seeking a Senior Lead Provider Network Onboarding and Integration to drive expansion... ...bridge providers, technology teams, and operations to ensure seamless connectivity and... ...enabling secure, scalable integrations across claims, #J-18808-Ljbffr Triwill GroupOperationsSeniorClaims
- Judi Health, a health technology company delivering unified claims processing, seeks a Project Manager, Corporate Compliance to plan,... ...organization. This role collaborates with Compliance, Legal, HR, IT, and Operations to ensure timely, compliant project delivery. Ideal candidates...OperationsSeniorClaims
- ...Senior Benefits Analyst Position Summary The Senior Benefits Analyst... ...strategic decision-making and operational excellence across the... ...Reporting Monitor and analyze claims spending, utilization trends,... ...Support Troubleshoot and monitor EDI file feeds to ensure accurate...OperationsEDISeniorClaimsWork at office
$136.19k - $170.24k
...for decades. Today, as a world-leading digital transformation partner... ..., sales, scheduling, plant operations, logistics, shipping, finance,... ...billing, returns, and customer claims. Design Oracle Fusion Order Management... ...procedures. Partner with EDI and integration teams to...OperationsEDIClaimsFull timeTemporary workVisa sponsorshipRelocation package$177.7k - $296.1k
...United States; E&S Property Senior Underwriter - Northeast Territory Lead We are adding to our diverse... ...delivering exceptional underwriting, claims, and risk management expertise to... ...profitability and growth targets. Operate within granted authority and...OperationsSeniorClaimsTemporary work- ...Facets , specifically supporting modules such as Claims, Membership, Enrollment, Eligibility, Benefits, Provider... ...Experience with healthcare claims processing and payer workflows. Experience testing HIPAA 5010 EDI transactions (837, 834, 270/271, 278, 820, 999)....EDISeniorClaims
- ...building the AI-native operating system for behavioral health... ...We’ve raised $41M from leading investors including... ...customers, including claim submission, authorizations... ...requirements across payers and levels of care Handle... ...Familiarity with EDI, eligibility verification...OperationsEDIClaims
$122.3k - $164k
...Enterprise Architect leads the strategic architecture... ...support healthcare payer and provider operations, with a focus on... ...using HL7, FHIR, X12/EDI, REST APIs, and event... ...platforms, CRM systems, ERP, claims platforms, and member... ..., Terraform, or API gateway platforms preferred....OperationsEDIClaimsWork experience placementFlexible hours- Judi Health is seeking a Senior Lead Provider Network Onboarding and Integration to drive onboarding, integration, and operational enablement of national and regional networks for the... ...business, ensuring connectivity with internal claims platforms. Responsibilities include...OperationsSeniorClaims
- The Gateway Development Commission (GDC) seeks a Senior Construction Claims Coordinator to support claims analysis, entitlement evaluation, and change management for the Hudson Tunnel Project (HTP). This role reports to the Chief Engineer and coordinates internal staff...SeniorClaims
$80k - $92k
...people worldwide through leading employers, health plans... ...is actively seeking a Payer Integration Manager to join our Health Plan Operations team. Reporting to the... ...Drive high first-pass claim acceptance rates by identifying... ...of healthcare EDI transaction infrastructure...OperationsEDIClaimsFull timeWork experience placementRemote workWorldwideSleeping nights- ...a Credentialing & Enrollment Lead who can own our multi-state provider... ...Medicare navigation company operating through a PC-MSO structure... ...understands the credentialing and payer enrollment landscape to... ...credentialing, MAC jurisdictions, or EDI enrollment. Why join us...OperationsEDIFull timeContract workPart timeLive in
- ...candidate should possess strong knowledge of healthcare payer operations, benefit plan design, claims processing, SQL, and end-to-end testing. Roles and... ...teams supporting Claims, Enrollment, Provider, Finance, EDI, and Customer Service. Maintain configuration version control...OperationsEDIClaims
- Seeking an EDI Analyst responsible for implementing, maintaining... ...providers, clearinghouses, and payers. The role involves resolving transaction errors affecting claims, eligibility, and remittances... ...critical role in maintaining smooth operational performance Scope of Role &...OperationsEDIClaimsFull timeWork at office
- EXL is seeking an experienced Senior Technology Transactions... ...managing, mentoring, or otherwise leading attorneys or a commercial contracting... ...or comparable healthcare payer/claims-adjacent services.Experience supporting global business operations across the U.S., Europe,...OperationsSeniorClaimsContract work
$118k - $178k
...Stop Loss Underwriting Practice Lead - Accident & HealthWho we are:... ...manage risk, transforming our operating model, and reshaping our role... ....Analyze group medical claims data, demographics, and plan designs... ...and understanding of healthcare payers, health plan administration,...OperationsClaimsFull timeWork at office- ...Cycle Systems Manager leads and oversees system configuration... ...is responsible for payer setup, EDI enrollment and... ...between system build and operational workflows to support efficient billing, claims processing, and cash... ...to support childcare, senior care, pet care, and...OperationsEDIClaimsContract work
- ...families. We partner with leading health plans, providers... ...serving healthcare payers, providers, and platforms... ...transform how they operate at scale. Navigate healthcare... ...and eligibility, claims and billing, scheduling... ...Health, athenahealth); X12 EDI transactions and...OperationsEDIClaimsFull timeFlexible hours
$105.4k - $207.8k
...Deployed Engineers operate at the intersection... ...powering provider and payer performance... ...data standards (e.g., claims, remittances, EMR data... ..., HL7, FHIR, X12 EDI), with the ability... ...-facing materials, lead technical discovery... ...level employees to senior leaders, we believe...OperationsEDIClaimsLocal area$110k - $125k
...HIPAA) requires that all insurance payers exchange transactions such as claims, eligibility checks, prior authorizations... ...remittances using a standardized EDI format called X12 HIPAA.... ...copywriting and precise targeting. You operate at a level above your peers. You are...OperationsEDIClaims$76.92k - $99.9k
Senior Software Test Engineer About the Role We are seeking a Senior... ...testing practices, healthcare EDI, HIPAA, PHI, CMS reporting, T-... ...Medicaid, Medicare, pharmacy, payer, provider, or government... ...Experience validating healthcare claims, encounters, eligibility, enrollment...EDISeniorClaimsWork experience placement- Nourish, a leading AI-native digital health platform in New York, seeks... ...billing and revenue cycle operations. You will resolve patient billing tickets, manage claim workflows, and help scale RCM processes... ...expands service lines and payer contracts. This role collaborates...OperationsSeniorClaimsRemote job
$55 - $60 per hour
...$55.00/hr - $60.00/hr EDI Operations Analyst Morristown, NJ... ...providing superior healthcare claim lifecycle solutions to... ...to our client by our Payer clients. Support Payer... ...testing Create, lead and facilitate... ...project requirements. Seniority level Seniority level...OperationsEDIClaimsFull timeContract workRemote work
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