Job Description
Job Description Job Title:
EDI Analyst
Exempt
Purpose of the Job:
The role of the EDI Analyst is to work with External Vendor Partners, the Business and IT team to ensure the timely and accurate processing of all data exchanges related to claim submission, eligibility request, claim status request and remits as well as all outbound files to new and established trading partners ensuring daily balance and controls of all in/outbound data.
Essential Job Functions and Responsibilities:
•Manage implementation of new direct connections and industry mandates
•Take ownership of file transmission issues and coordinate resolution between business and IT
•Manage production validation tasks as a part of Go Live
•Analyze EDI data to troubleshoot or optimize business processes and needs.
•Maintain a full understanding of all inbound/outbound files for assigned routes
•Analyze response parsing errors and effectively communicate program requirements to IT Trading Partner team
•Maintains relationship and needs of the business owner for partner integration.
•Ability to compare large data sets for reconciliation.
•Assist in User Acceptance Testing
•Pursue better connectivity options for automation, security, and performance
•Ensure inbound/outbound files are are received from trading partner's FTP/website once available.
•Alert internal teams of any variance in receipt of transactions
•Review trading partner emails to ensure issues/changes are communicated and addressed
•Assist with production issues
•Research and address internal requests for assistance received from the organization
•Perform other duties as assigned by leadership within the area of responsibility and
control.
Requirements Required Job Skills:
•Understanding of XML/ANSI 834 / HIPAA X12 transactions would be beneficial.
•In lieu of degree, minimum 2- 3 years proven EDI/eligibility experience
•Strong communication and analytical skills required.
•2-3 years experience with standard EDI file formats and protocols such as 837P, 837D,835, 834, 277, 999.
•Excellent knowledge ADA, CPT and HCPCS procedures and codes.
•experience in EDI and/or information systems
•experience in data analysis, data management and integration, extracting and analysis reporting
•Ability to read EDI transactions
•Knowledge of EDI transactions, 834, 835, 837 and 27X
•Intermediate knowledge of data mapping techniques and data analysis software.
•Intermediate knowledge of computer operating systems.
•Intermediate knowledge of Microsoft Applications and Suites, Windows Server, and Microsoft SQL databases.
Compensation: 60K-80K annually
As an Equal Opportunity / Affirmative Action Employer, Aither Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Aither Health will not tolerate discrimination or harassment based on any of these characteristics. Aither Health encourages applicants of all ages. Aither Health
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