The posting
About Aptia
Founded to shape the future of pensions, health, and insurance solutions, Aptia is a leading professional services firm dedicated to simplifying complexity for businesses and individuals. We bring together cutting-edge technology and deep industry expertise to help organisations navigate an evolving landscape with clarity and confidence.
With a presence in the US, UK, India, and Portugal, we support over six million people and more than 1,100 clients, delivering solutions that drive efficiency, enhance financial security, and provide peace of mind.
Our strength lies in the combination of smart technology and expert teams, ensuring that managing pensions, health, and insurance is more effective. By focusing on innovation, accessibility, and client success, we help businesses take care of their people, so they can focus on what they do best.
And we are expanding. Aptia Group is not only fueled by our investors' backing but also by our commitment to foster the growth and success of our people. At Aptia, we're investing heavily in learning and development, paving unique career paths for our colleagues.
Specialist. Responsive. Thoughtful. Our values aren't just words; they are the backbone of our business. Our team embodies our values daily, to surpass client expectations, evolve constantly and nurture genuine relationships for the long-term.
Job requirements
Job Summary
The purpose of this job is to perform carrier integration activities that support the successful transmission and maintenance of eligibility and enrolment data with external carrier partners. The role is responsible for managing 834 EDI and non-834 carrier files, resolving file-related issues, and ensuring accurate and timely delivery of carrier data.
Key Responsibilities
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Monitor and manage daily inbound and outbound carrier eligibility file processing, including 834 EDI files and carrier-specific non-834 file formats, ensuring timely and accurate delivery.
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Analyze and resolve carrier file discrepancies, rejects, transmission failures, and enrollment exceptions to ensure data accuracy and successful processing.
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Perform validation and quality assurance checks on carrier files to identify and correct eligibility, demographic, and coverage data issues prior to transmission.
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Investigate and troubleshoot file-related issues raised by carriers, clients, and internal teams, coordinating resolution with appropriate stakeholders.
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Support implementation and maintenance of carrier file mappings, business rules, and file specifications for new and existing carrier integrations.
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Monitor and work on all incoming issues received through team mailboxes, ticketing systems, and service requests, ensuring timely resolution and escalation when required.
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Complete recurring operational tasks related to carrier file generation, transmission, reconciliation, and error resolution for assigned clients.
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Conduct file audits and reconciliations to identify potential enrollment discrepancies and ensure alignment between source systems and carrier records.
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Update and maintain carrier integration documentation, file layouts, process procedures, and testing results.
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Support testing activities for carrier changes, new implementations, system enhancements, and regulatory updates impacting carrier file exchanges.
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Identify process improvement opportunities and recommend automation or operational efficiencies related to carrier integrations and EDI file management.
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Support Team Lead by providing peer-to-peer guidance, knowledge sharing, and assistance with process updates and operational changes.
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Assist in training and mentoring new and existing team members on carrier integration processes, file specifications, troubleshooting techniques, and best practices.
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Build and maintain effective working relationships with carriers, implementation teams, operations teams, and technology partners to support successful file exchange operations.
Required Skills and Experience
Must-Have
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Must have knowledge of the US Health & Welfare (H&W) Benefits domain, including eligibility, enrollment, and carrier data exchange processes.
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Strong understanding of Carrier Integration processes, including 834 EDI transactions, carrier-specific non-834 file formats, eligibility file management, enrollment and termination processing, file reconciliation, and transmission monitoring.
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Experience in analyzing and resolving carrier file discrepancies, enrollment mismatches, file rejects, transmission failures, and data quality issues.
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Strong verbal and written communication skills with the ability to clearly communicate file-related issues, root causes, and resolution plans to internal and external stakeholders.
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Strong organizational and time management skills, including the ability to prioritize multiple tasks, manage competing deadlines, and support multiple carrier integrations simultaneously.
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Excellent analytical and problem-solving skills with the ability to investigate, troubleshoot, and resolve complex file integration and data exchange issues.
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Working knowledge of EDI standards, file layouts, data mapping, validation rules, and carrier-specific implementation requirements.
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Must have knowledge of carrier file configuration, file mapping, and file generation processes within Javelina.
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Must be familiar with employee demographic and enrolments data lookup, validation, and troubleshooting within Javelina.
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Experience performing data audits, reconciliations, and quality assurance reviews to ensure accuracy and completeness of carrier file transmissions.
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Ability to interpret carrier file specifications, business requirements, and operational procedures to support implementation and ongoing maintenance activities.
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Demonstrated ability to work independently as well as collaboratively within a team environment, while proactively identifying risks and driving issue resolution.
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Experience supporting testing activities for new carrier implementations, file changes, system enhancements, and production releases.
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Strong attention to detail with a focus on data integrity, compliance, and operational accuracy in a high-volume processing environment.
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Experience
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3.5 + years of experience in Benefits Administration, Carrier Integration, EDI processing, eligibility and enrollment administration, or operations support.
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Experience working with 834 EDI and non-834 carrier files, including file reconciliation, issue resolution, and data validation.
Education
• Any graduate degree or equivalent qualification from a reputable institute.
How to apply
If you are interested in this role, then we’d love to hear from you. Please go ahead and click apply and submit your resume with appropriate contact information.
Aptia is committed to creating a diverse, inclusive and equitable work environment. At Aptia, fostering an equitable and inclusive environment for all our people to flourish is a priority. We are an equal opportunity employer and aim to attract and retain the best people without attention to age, background, disability, ethnic origin, family duties, political affiliation, race, religion, gender and sexual orientation.
If there are any reasonable adjustments we can make to the recruitment process to ensure it is accessible to you, we encourage you to reach out to us.
