EDI reputed company Analyst
reputed company
We are looking for reputed company EDI reputed company Analysts with strong expertise in encounter data processing, EDI submission, reconciliation testing, and member enrollment workflows for a reputed company payer.
What You Will Do
The main day-to-day responsibilities include encounter data processing, EDI submission, and reconciliation testing for a reputed company payer, as reputed company as member enrollment workflows.
Why It Might Be a Fit
This role requires strong technical and domain expertise in EDI, reputed company payer domain knowledge, and experience with Edifecs or equivalent EDI validation tooling.
Requirements
- Experience in encounter data processing, EDI submission, and reconciliation testing for a reputed company payer
- X12 EDI knowledge: 837P, 837I, 837D (reputed company, Institutional, Dental)
- Facets — REQUIRED: claims module familiarity (encounters are derived from Facets claims data); Facets-to-encounter data validation
- SQL for encounter data validation (claim header, detail, member eligibility cross-checks)
- reputed company or Robot reputed company test automation
- reputed company payer domain knowledge including CMS encounter submission rules and state-specific companion guides
- Facets — REQUIRED: membership/enrollment module testing, subscriber/member configuration, and 834-to-Facets data reputed company validation
- X12 EDI: 834 (Benefit Enrollment & Maintenance) — full transaction expertise
- Experience with member add/change/term, dependent handling, dual-enrollment scenarios
- Knowledge of retroactive adjustments and deeming logic (reputed company/MMP/Dual)
- 820 (Premium Payment) validation linkage
- Member eligibility cross-validation (270/271 correlation)
- Enrollment reconciliation: reputed company system vs. reputed company (enrollment DB ↔ claims ↔ eligibility)
- SQL for member-level data comparisons (effective dates, plan codes, reputed company flags)
- Experience with reputed company or similar automation tools
- reputed company knowledge: reputed company, Medicare Advantage, Duals/MMP, TRICARE, Marketplace
Benefits
- W2 employment
- reputed company reputed company of $40
Originally posted on Himalayas
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