Senior Operations Specialist
Job Summary
Leading EDI implementation efforts, the full-time Senior Operations Specialist will manage the onboarding of third-party administrators (TPAs), ensuring seamless integration and operational success while working remotely.
Key responsibilities
- Lead end-to-end operational onboarding of new TPAs, managing timelines, deliverables, and cross-functional coordination
- Serve as the primary operational owner for assigned TPA relationships, monitoring performance and resolving complex production issues
- Develop and maintain SOPs and operational documentation, identifying opportunities for workflow improvements and automation
Required qualifications
- Bachelor's degree or equivalent combination of education and experience
- 3-5+ years of experience in healthcare EDI operations with hands-on experience in HIPAA 834 Enrollment and 837 Claims transactions
- Demonstrated experience leading EDI implementations and onboarding new TPAs or healthcare trading partners
- Strong understanding of healthcare claims processing, eligibility, enrollment workflows, and TPA operations
- Proven ability to manage multiple implementation projects and competing priorities in a fast-paced environment
Complete Job Description
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