EDI Analyst

Custom Business Solutions, Inc.; Michigan; On-site; USD 70,000 - 95,000; Full time

Job summary

Custom Business Solutions, Inc. is seeking an EDI Analyst to support the EDI Operations department.

You will interface with business analysts, software developers, project managers, trading partners, and software vendors to manage enrollment, claims, financial, and eligibility transactions using ANSI X12 HIPAA formats. The role emphasizes implementing and supporting EDI connections, monitoring processes, resolving issues, performing UAT, and providing on-call support to ensure smooth, compliant

Qualifications

• Knowledge of EDI standards and how data exchange works between partners.
• Experience reading/analyzing/formatting/translating EDI data using SQL.
• Ability to set up and troubleshoot SFTP connections with partners.
• Experience implementing EDI setup and mapping.
• Willingness to support post-production and UAT activities.

Responsibilities

• Interface with internal/external customers to understand work requests and process them.
• Implement and support EDI connections with clients and partners; monitor and resolve issues.
• Verify, monitor, and troubleshoot EDI processes; document procedures.
• Assist in defining enhancements and upgrades for EDI systems.
• Provide on-call support as necessary.

Skills

EDI

SQL

SFTP

Data analysis

Communication

Tools

Facets software

Job description

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. This role is 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. Handles multiple enhancement requests and projects.

Essential Functions:

• Demonstrate knowledge of EDI standard formats and communicate complex data exchange concepts to internal and external parties. Interface professionally with various internal and external customers including Operations, Sales, Marketing, IS, and Trading Partners to understand and process work requests.
• Responsible for the implementation of electronic data interchange connections between client and external parties. 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. Develop and maintain procedural documentation. Follow-up comprehensively with all stakeholders during issue remediation process to assure that delays are minimized and the process runs smoothly.
• Assist in defining application enhancements and upgrades.
• Perform application configuration, mapping, and monitoring of EDI transactions and processes.
• Support application testing effort by performing user acceptance testing (UAT) and assisting in defect resolution.
• Provide on-call support as necessary.

Requirements:

• Must be able to facilitate SFTP connection setup between internal and external partners
• Must be able to support file/transaction processing, including error triage and resolution
• Must demonstrate knowledge of EDI 834 standard
• Relevant experience Analyzing EDI data to identify content and/or formatting issues
• Relevant experience Using SQL queries to retrieve and/or display data
• Must have the ability to communicate complex data exchange concepts to internal and external partners
• Experience Reading/analyzing/formatting/translating EDI data
• Experience Implementing EDI setup and mapping

Nice to Have

• Ability to create/run SQL queries
• Knowledge to interpret query resultsExperience in the healthcare industry
• Experience with Facets software or a similar healthcare enrollment/claims management software system

NO C2C