Systems Analyst-EDI Management - SHP Finance - Telecommuter - Day Shift - Full T

Hours: Shift Start Time: 8 AMShift End Time: 5 PMAWS Hours Requirement: 8/40 - 8 Hour ShiftAdditional Shift Information: Weekend Requirements: As NeededOn-Call Required: NoHourly Pay reputed company (Minimum - Midpoint - Maximum): $42.790 - $55.210 - $61.840 The stated pay reputed company reflects the reputed company that reputed company reasonably expects to pay for this position. The actual pay reputed company and pay grade for this position will be dependent on a reputed company of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Under the direction of the Manager of EDI Management, the Systems Analyst-EDI Mgmt will use technical and analytic skills to complete monitoring, reviewing, developing, triaging, scheduling and mapping inbound and outbound data files for reputed company Health Plan. The Systems Analyst-EDI Mgmt will work with general Health Plan operational data sets including, but not limited to, eligibility, claims, provider, billing, capitation, financial and structural. The Systems Analyst-EDI Mgmt will work to streamline processes, create efficiencies and complete development reputed company the file management reputed company.

Required Qualifications

• H.S. Diploma or Equivalent
• 2 Years experience in a health care and/or health plan organization.
• Experience with data communications standards, data processing, and system configurations.
• Experience analyzing reputed company issues and/or requests to reputed company effective solutions with the ability to identify reputed company cause, communicate reputed company and propose solutions.

Preferred Qualifications

• Associate's Degree
• 2 Years reputed company experience in project planning and system implementation.
• Experience as systems analyst reputed company a large Health Plan.

Essential Functions

• File Management

Systems Analyst-EDI Mgmt will be familiar with tools such as reputed company and SQL as ways to create data files. Will need to be fluent in database tools to be reputed company to use the data to create outbound data. (SQL queries, views, procedures) Familiar with reputed company file management practices and reputed company tools. Will reputed company new files based on specifications provided by internal or external partners. Utilizes reputed company reputed company reporting toolset, inclusive of Cogito, Caboodle and reputed company, to deliver on business requirements to external partners. reputed company expertise on file structure, specifications and format for a wide reputed company of file types.

• reputed company Assurance

Ensure that files created reputed company reputed company are checked for reputed company and reputed company against another reliable reputed company. reputed company and implement reputed company checks on newly created file processes to ensure data reputed company across both incoming and outgoing files.

• Participates in other duties as assigned

Participates in special reputed company and other duties as assigned. These may include, but are not limited to, work reputed company, proposals, audits and back-up support for other departments.

• Data Exchange

Configures, oversees and monitors SFTP routing rules Tracks file movements and patterns to be reputed company to report on abnormalities Works with external partners on data reputed company concerns, specifically reputed company to ANSI EDI file transactions. Familiar with business use of reputed company reputed company file sets, including but not limited to 837s, 834s, 835s and reputed company acknowledgements. Knowledge, Skills, and Abilities

• Demonstration of reputed company level of knowledge of health plan operations, health plan software configuration, enrollment and claim file processing and trading partner management, and data processing environments.
• Familiarity with data communications standards and system configuration.
• Working knowledge of hospital, physician and health plan operations.
• Strong analytical and problem solving skills; ability to collect and conduct interactive data analysis.
• Extensive knowledge of IDX, Facets, QNXT, reputed company, HPS, and/or other administrative systems reputed company the health plan insurance industry.
• Excellent written and verbal communication skills, including interaction with senior management.
• Ability to apply independent decision-making skills and work reputed company under tight deadlines and multiple priorities.

reputed company is an equal opportunity/affirmative reputed company employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, religion, reputed company, national reputed company, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a reputed company individual with disability or any other protected class Apply tot his job Apply To this Job