EDI Analyst- Level III GHN-Online
This resource has responsibility for payer edits, payer connectivity and translations/interpretation of payer rejections to
provide EDI expan-sion for the company. Individual will be responsible for executing against EDI projects, as well as
possess the ability to perform mapping of standard data formats. In this job function, he/she will be a key contact for
trading partners and value-added network vendors.
Responsible for supporting processes related to inbound and outbound EDI transactions
Responsible for configuration of edits and business rules for clients and new payers
Responsible for coordinating the support of any ancillary EDI functions to facilitate successful execution of the claims
Responsible for testing and quality assurance of new edits; and new payer connectivity
Responsible for providing written EDI product/service requirements, generating test cases, quality assurance and
providing on-going technical EDI support.
Responsible for maintenance of company payer tables
Responsible for assuring compliance of payer requirements (edits, jurisdiction changes, telecom changes, trading partner
agreements renewals, testing, rejection message translations).
Responsible for providing payer rejection message translations into our various products/services.
Education, Knowledge, Skills and Ability Requirements
Bachelor?s Degree preferred
5-6 years experience working with healthcare providers using institutional and professional claim forms.
5-6 years experience with the structure and syntax of the ANSI X12 834, 835, 837I, 837P, 270/271, 276/277 and
supporting acknowledgement/claim status transactions are critical.
5-6 years experience working with EDI, EFT, XML transaction processing, and data mapping.
4-5 years experience working development teams.
4-5 years experience working with telecommunication protocols-- SFTP, FTP, BBS, HTTPS.
2-3 years experience of project management, business analysis, and quality assurance in an application development
Experience with MS-SQL database centric applications in T-SQL, VB / VB.Net, C# or C/C++ in healthcare environment, a
Experience in BIZTALK 2009 environment, a plus.
Essential Functions of the Job
Strong analytical skills
Professional written and oral communications skills;
Ability to work independently
Ability to be a team player
Working knowledge of various EDI validation services; CLAREDI, EDI DEV, EDIFECS
Working knowledge of all Microsoft Office applications (Excel, Word, PowerPoint, and Visio)
Possess a strong work ethic
Be persistent and dependable
Be able to produce quality work
Possess good time management skills & detail oriented
||12655 North Central Expressway |
Dallas, TX 75243