Claims Implementation Analyst
Horsham, PA 
Posted Today
Job Description
Claims Implementation Analyst

Job Responsibilities:

  • Meet with clients and discuss what is expected during their implementation process
  • Gather client information for configuration and setup in the Clearinghouse portal
  • Implement and support new clients until they are moved to Support
  • Take clients through testing phase and analyze 837 Claim files
  • Train clients on the Clearinghouse portal for Claims, ERA, and Denial Rejections
  • Monitor and support new client accounts until transitioned to Support
  • Understand the business needs, evaluate alternatives and justify the recommended approach as part of preparing the business case, for multiple EDI Solutions
  • Account Managers assess each client's needs and expectations. Account Managers are the link between developers and stakeholders
  • Facilitate communication and knowledge sharing to ensure clients' needs are met effectively
  • Performs analysis of data sources and processes to identify areas of opportunity. At times the AM may need to get first-hand information by communicating directly with customers, conducting surveys and carrying out interviews
  • Analyzes the structure of the solutions, its processes and determines areas in which technology or alternative solutions
  • Collaborate with other key team members and sometimes across software to determine how to design new solutions or enhancements
  • Collaborate with numerous stakeholders within the company to ensure that their concerns, requirements, and contribution are included in the requirements specification document
  • Evaluates the business needs, makes sense of the available information and ensures that the project team understands all the details they require
  • Prepare the project charter, which involves defining high-level project requirements, can help management make decisions on whether to approve or not approve the project
  • While a project is active, the AM may be called upon to provide clarity to developers, negotiate with stakeholders on conflicting requirements. This may include holding meetings to deliberate on solving specific problems, identify risks and manage technology-related restrictions
  • Organize the requirements into a formal and written document which can be shared with all stakeholders. This requires the candidate to have the expertise to present the results of the analysis in an accurate, clear and understandable manner
  • May or may not be involved in the QA of the final product
  • A daily willingness to troubleshoot, understand and resolve technical and business issues
  • Effectively manage multiple tasks and prioritize while working in a fast-paced environment
  • Other assigned duties as needed
  • 3 plus years of Customer Service experience
  • 3 plus years' experience in EDI or Healthcare IT
  • 1-3 years Clearinghouse experience
  • Project Management or Project Implementation experience a plus
 Knowledge, Skills & Abilities:
  • Effective written and communication skills
  • Demonstrate problem solving and researching skills
  • Strong organizational and interpersonal skills
  • Experience with Microsoft Excel (document creation, editing, sorting, saving, and storing)
  • Proficient with Microsoft Word (document creation, editing, sorting, saving, and storing)
  • Proficient with Microsoft Outlook (email organization and calendar scheduling)
  • Knowledge of technical troubleshooting approaches, tools and techniques, and the ability to anticipate, recognize, and resolve technical (hardware, software, application or operational) problems
  • Proven ability to quickly learn new applications, processes, and procedures
  • Display a high degree of motivation and the ability to work independently
NextGen Healthcare believes in strength through diversity. We are an equal opportunity workplace and an affirmative action employer supporting Diversity, Disabled, and Protected Veterans. Qualified applicants are considered for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, gender identity, disability or veteran status.

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Because NextGen Healthcare believes in providing a safe work environment, we conduct background checks as part of our hiring processes.


The EDI Account Manager will be responsible for implementing, configuring and training our clients on the NextGen Clearinghouse.

795 Horsham Road, Horsham, Pennsylvania 19044
3525 Piedmont Road NE Building 6, Suite 700, Atlanta, Georgia 30305


Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
3+ years
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