Title: EDI Analyst

VMS Requisition ID: SPTMJP00006358

Work Location: Grand Rapids, MI


Description: 100% REMOTE

Job Summary

Provides support for the EDI Operations department by interfacing with internal and external customers including business analysts, software developers, project managers, trading partners, and software vendors. Responsible for responding to requests from users, both internal and external, related to updates, changes, and/or modifications related to the EDI system and its integrations. Also responsible for managing a range of EDI transactions including enrollment, claims, financial, and eligibility transactions using ANSI X12 HIPAA compliant formats. Provides technical support for the implementation of EDI connections with external parties; responds to inquiries related to EDI transactions; conducts analysis of EDI transactions; and provides issue resolution when necessary. Acts as a consultant to identify operational procedures, define system requirements, and determine acceptable UAT results ultimately leading to Production implementation. Handles multiple enhancement and project requests as well as day to day operations in addition to acting as a lead for the EDI Operations team.

Essential Functions

Responsible for the implementation of electronic data interchange connections between Priority Health and external parties. Perform application configuration, mapping and monitoring of EDI transactions and processes. Support application testing effort by performing UAT and assisting in defect resolution. Support ongoing implementations in post-production, including error identification/resolution, continuous improvement, and pro-active communication with the trading partners and providers to reduce/prevent errors.
Verify and monitor EDI processes. Troubleshoot and resolve EDI related issues varying complexity. Develop and maintain procedural documentation. Follow-up comprehensively with all stakeholders during the issue remediation process to assure that delays are minimized and the process runs smoothly. Act as a liaison and technical advisor between EDI Operations and various levels of personnel within the organization as well as external parties
Assist in managing application enhancements and upgrades as well as coordination of various tasks including day-to-day operations and project tasks.
Support compliance requirements and assist in making updates when/if necessary to ensure the EDI system and processes remain compliant. Identify areas of opportunity and propose solutions to improve productivity and application performance. Lead the team in the adoption of standard work processes.
Demonstrate the ability to be self-sufficient and to manage time and workload appropriately. Recognizes when to make decisions independently and when management consultation is necessary. Maintains appropriate office hours and provides on-call support as necessary.
Assist in leading the implementation of change and process improvements. Lead the team in the adoption of change while emanating a positive attitude toward change.
Provide exceptional and responsive customer service to clients, both internal and external. Assume ownership of tasks. Demonstrate the desire to be collaborative and cooperative. Encourage positive interaction, listens to others, is open-minded and is aware of the audience to allow for any communication adjustments that may be necessary. Represent the EDI Operations team in a professional manner.

Qualifications

Required Bachelor's Degree or equivalent related field
5 Years of Edifecs configuration and/or development experience Required
5 years of relevant experience Analyzing data to identify content and/or formatting issues Required
5 years of relevant experience Using SQL queries to retrieve and/or display data Required
5 years of relevant experience Reading, formatting, and translating EDI data Required
5 years of relevant experience Implementing EDI setup and mapping Required
5 years of relevant experience In the healthcare industry Required
5 years of relevant experience With Facets Software or a similar healthcare enrollment/claims management software system Preferred




Required Skills: Required Bachelor's Degree or equivalent related field 5 Years of Edifecs configuration and/or development experience Required 5 years of relevant experience Analyzing data to identify content and/or formatting issues Required 5 years of relevant experience Using SQL queries to retrieve and/or display data Required 5 years of relevant experience Reading, formatting, and translating EDI data Required 5 years of relevant experience Implementing EDI setup and mapping Required 5 years of relevant experience In the healthcare industry Required 5 years of relevant experience With Facets Software or a similar healthcare enrollment/claims management software system Preferred
Basic Qualification:
Additional Skills:
Background Check: Yes
Drug Screen: Yes
Notes: 100% Remote
Selling points for candidate:
Project Verification Info:
Candidate must be your W2 Employee: Yes
Exclusive to Apex: No
Face to face interview required: No
Candidate must be local: No
Candidate must be authorized to work without sponsorship: No
Interview times set:: No
Type of project:
Master Job Title: Misc: Non-Technical
Branch Code: Minneapolis

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