Product Manager for EDI Claims

Job Summary

A company is looking for a Product Manager to lead the strategy and optimization of EDI claims processing capabilities.

Key Responsibilities

• Own the product roadmap for EDI claims processing, focusing on transaction workflows
• Collaborate with engineering and operations teams to optimize claims processes
• Define and track KPIs related to claims submission and adjudication

Required Qualifications

• Minimum 5 years of experience in healthcare EDI, specifically with 837, 835, and 277 formats
• Proven experience in risk adjustment within managed care or value-based care environments
• Strong understanding of HIPAA X12 standards and CMS submission protocols
• Experience with claims lifecycle tools is a plus
• Excellent stakeholder management skills