Claims Analyst

Global Information Technology; Southfield (MI); Remote; USD 41,000 - 83,000; Part time

Job summary

Global Information Technology is seeking a Remote EDI Claims Analyst for a contract engagement. The role focuses on analyzing and processing electronic data interchange (EDI) transactions, including claims and eligibility inquiries, while collaborating with provider relations, IT, and internal teams to ensure accurate data submission and smooth processing.

The ideal candidate will bring strong EDI and claims knowledge, SQL/data analysis skills, and familiarity with industry platforms such as

Qualifications

• Strong understanding of EDI transactions and claims processing.
• Proficiency in SQL and data analysis.
• Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica, and Apigee.
• Familiarity with CBH systems, including Connects and Flexicare.
• Excellent problem-solving and analytical skills.
• Ability to mentor and train team members.
• Executive leadership client facing.

Responsibilities

• Analyze and process EDI transactions including claims and eligibility inquiries.
• Review and resolve claim rejections and ensure accurate data submission.
• Collaborate with provider relations, IT, and internal teams to ensure smooth processing.

Skills

EDI transactions & claims processing

SQL & data analysis

Problem-solving & analytical skills

Mentoring & training team members

Executive leadership client facing

Tools

Edifecs Smart-Trading

Availity Essentials

Informatica

Apigee

CBH Connects

CBH Flexicare

Job description

Job Title: EDI Claims Analyst

Job Location: Remote
Job Type: Contract

The EDI Claims Analyst is responsible for analyzing and processing electronic data interchange (EDI) transactions, including claims and eligibility inquiries. This role involves reviewing and resolving claim rejections, ensuring accurate data submission, and supporting various EDI transactions. The analyst will work closely with provider relations, IT, and other internal teams to ensure smooth and efficient claims processing.

Requirement:

• Strong understanding of EDI transactions and claims processing


• Proficiency in SQL and data analysis


• Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica, and Apigee


• Familiarity with CBH systems, including Connects and Flexicare


• Excellent problem-solving and analytical skills


• Ability to mentor and train team members


• Executive leadership client facing