Implementation Specialist
Chamberlin Edmonds - St. Louis, MO

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Title: IMPLEMENTATION SPECIALIST I

Headquartered in Nashville, TN, Emdeon is a leading provider of intelligent revenue cycle management solutions that accelerate and simplify the payment cycle for healthcare providers, payers, and patients. Emdeon empowers healthcare providers through innovative revenue cycle management solutions by tapping the most complete network of payers, partners, and resources in the healthcare industry. Our uniquely efficient services simplify the business of healthcare to save our clients time and money so they can focus on their core competencies.

Emdeon employs approximately 3,400 employees across all geographical segments. Emdeon is the clear leader in outbound document fulfillment for healthcare companies. With our broad range of clients, Emdeon is continually raising industry standards for this process. Our facility in St. Louis, Missouri, is a state-of-the-art operation and encompasses high-volume printing and mailing of provider checks, EOBs, letter correspondence, bills, and reports. Other services that Emdeon provides surrounding this process are: full web access and control through the Client Access System, unparalleled postage savings through the Healthpayers USA postage program, imaging services for all client documents and electronic delivery of information and payment through our ePayment solution and other web presentment functionality.

SECTION I: RESPONSIBILITY
After a client (Payer, TPA or insurance company) has signed a contract with Emdeon, this individual will guide the client through a 1-6 month implementation schedule to begin processing the client’s live data through our system. Duties include:
• Manage the implementation of new clients
o Initial contact with client to “kick off” the implementation process; this includes discussing products to be implemented per their signed contract and setting expectations with the client to complete the implementation as a team
o Collect and analyze client’s data and requirements
o Develop scope of the project. This includes utilizing alternate file formats (AFF), noting where the data goes and converting this data into an 028 file for the Emdeon Vendor file. The IT group will then convert this into the FoxPro programming language.
o Open, read and understand data files
o Develop statement of work in collaboration with internal IT and the client
o Develop and manage internal and external project plans with aggressive timelines
o Interact with IT to develop code for interpreting client data
o Set up new client in Emdeon’s Client Access System, customizing group settings
o Design forms using our proprietary software.
o Mass addition of groups and rules using Foxpro tables
o Create test cases (with several scenarios) that consider the business requirements
o Test client’s data applying form and group settings to accomplish client’s desired output, such as checks, explanations of benefits, member letters, etc.; I
o Manage all communication with the client including conducting meetings and conference calls
o Consult with managerial and system analysis personnel to develop new system solutions to accommodate clients specific data and needs
o Generate process documentation for each implementation to be used for the turnover of the client to the Client Services department and for future business growth
o Ensure successful processing of clients live data prior to concluding implementation and turning the client over to the Client Services department.
• Understand medical claims, insurance related documents, print and electronic processing solutions
• Understand Payer Services technical systems and software.
• Understand Payer Services products including EOBs, checks, ID cards, invoices, letters, eEOBs, web portals, data WebAPI, commission statements, capitation statements, member booklets, SPDs, Medicare part D, Medicare documents, CFA, UBs, ADA forms, eFT, PDF indexing, 835s and virtual credit cards
• Periodically visit client locations
• Adhere to security policies and procedures
• Carry out responsibilities with highly ethical behavior, especially as it relates to HIPAA regulations
SECTION II: KNOWLEDGE AND SKILLS
• Strong technical problem solving skills
• Working knowledge of spreadsheets, databases and business logic; this includes SQL, FoxPro, and basic programming and query knowledge
• Working knowledge of Microsoft Project
• Knowledge of all file types such as XML, delimited, fixed data, PDF, print files and vendor files (WLT, RIMS, Genelco, Luminex, Texen, SBPA, El Dorado)
• Knowledge of 028 file creation, form design and basic system knowledge
• Knowledge of the proprietary Client Access System and Multi Channel Distribution System
• Technical agility to adapt to new computer applications quickly
• Healthcare and Insurance Industry Experience
• Customer Service Skills
• Able to communicate with various organizational levels and departments
• Able to work on multiple projects/priorities in a deadline-driven environment
• Excellent communication and interpersonal skills
• Medical Billing experience preferred
• College degree preferred
SECTION III: DESIRED START DATE TBD
SECTION IV: COMPENSATION Base Salary + Commission
SECTION V: HOURS 45+ hours/week
SECTION VI: TRAVEL Minimal
SECTION VII: EXTERNAL COMPARISON
40% Project Manager I
10% Software Developer I
50% Business Analyst I
SECTION VII: PROGRESSION
To qualify for a progression to the next level of Implementation, the Implementation Specialist must show solid results and meet 100% of the skill set necessary to meet expectations of the next level.
Implementation Analyst I
• Implement Vendor Letters of Intent for monthly print volumes less than 20,000
• Implement AFF Letters of Intent for monthly print volumes less than 50,000
• Process live client changes
• Successfully implement 6 clients or more in a 6 month consecutive window
• Maintain project schedule/matrix for all clients
• No negative customer feedback for three consecutive months
• Implement existing clients with new business
SECTION II: KNOWLEDGE AND SKILLS
• Strong technical problem solving skills
• Working knowledge of spreadsheets, databases and business logic; this includes SQL, FoxPro, and basic programming and query knowledge
• Working knowledge of Microsoft Project
• Knowledge of all file types such as XML, delimited, fixed data, PDF, print files and vendor files (WLT, RIMS, Genelco, Luminex, Texen, SBPA, El Dorado)
• Knowledge of 028 file creation, form design and basic system knowledge
• Knowledge of the proprietary Client Access System and Multi Channel Distribution System
• Technical agility to adapt to new computer applications quickly
• Healthcare and Insurance Industry Experience
• Customer Service Skills
• Able to communicate with various organizational levels and departments
• Able to work on multiple projects/priorities in a deadline-driven environment
• Excellent communication and interpersonal skills
• Medical Billing experience preferred
• College degree preferred

Chamberlin Edmonds - 23 months ago - save job
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Chamberlin Edmonds, an Emdeon company, is a leading provider of comprehensive eligibility and enrollment services with over 26 years of...