EDI Analyst I

Utah

Murray, Northern (UT, KY)

Hybrid

USD 60,000 - 78,000

Full time

10 days ago

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Job summary

University of Utah Health Plans in Murray, UT seeks an EDI Analyst at Level I or Level II to support health plan enrollment, claims, payments, and clearinghouse activities. This role provides technical support during and after EDI implementations and works under the EDI Analyst Senior.

Candidates should have IT experience, MS Office proficiency, data analysis skills, and knowledge of ANSI X12 transactions and health plan data flows. Strong communication and teamwork are essential.

Qualifications

Associate's degree or IT-equivalent experience.
Proficient in Microsoft Office applications.
Experience in collecting, organizing, analyzing, and presenting data.
Knowledge of health insurance data and ANSI X12.
Experience with EDI processes and health plan data flows.

Responsibilities

Performs EDI setups of clearinghouse information and ACH payments to customers following specified procedures.
Maintains procedures as needed with appropriate updates.
Performs setups of data exchanges between entities for health plans.
Validates data locations from customer data feeds.
Maps data feeds into Health Plan formats.
Where appropriate, loads, monitors and tests incoming and outgoing EDI transactions in a timely manner.
Ensures the accuracy of data, analyzes conflicting data, works with partner entities to verify and resolve data errors.
Communicate in a professional manner with customers and team members when there are problems or changes required.
Provides documents to providers and outside agencies as required.
Assist with projects as required.

Skills

MS Office

Data analysis

Health data standards

EDI ANSI X12

Customer communication

Teamwork

Education

Associate's degree in IT

Equivalent IT experience

Tools

Epic Tapestry

Microsoft Office

Job description

Overview

*This position is open to a level I or level II EDI Analyst; the requirements for each level is listed below*

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

This position for use in Health Plans Departments only. Under the supervision of the EDI Analyst Senior, this position will provides technical support during and after the implementation of the health care Electronic Data Interchange (EDI) setups. Responds to inquiries regarding EDI issues with enrollment, claims, payments and/or clearinghouse activities. This position is not responsible for providing care to patients.

Corporate Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

Responsibilities

Performs EDI setups of clearinghouse information and ACH payments to customers following specified procedures.
Maintains procedures as needed with appropriate updates.
Performs setups of data exchanges between entities for health plans..
Validates data locations from customer data feeds.
Maps data feeds into Health Plan formats.
Where appropriate, loads, monitors and tests incoming and outgoing EDI transactions in a timely manner.
Ensures the accuracy of data, analyzes conflicting data, works with partner entities to verify and resolve data errors.
Communicate in a professional manner (verbal and written) with customers and team members when there are problems or changes required.
Provides documents to providers and outside agencies as required.
Assist with projects as required.

Knowledge / Skills / Abilities

Ability to use office desktop tools effectively (e.g. word processing, email, presentation software and spreadsheets).
Demonstrated ability to utilize spreadsheets to find trends or problems with data sets.
Knowledge of health insurance industry data and standards.
Knowledge of processes and procedures of various health plan claim flows from intake to provider payment.
Demonstrated customer relations and effective communication skills.
Ability to work well alone or in a team setting.
Ability to perform the essential functions as outlined above.

Qualifications

Required for Level 1

Associate's degree, or equivalent experience in an IT setting.
Proficient in Microsoft business applications.
Experience in collecting, organizing, analyzing, and presenting data.

Required for Level 2

Associate's degree, or equivalent experience in an IT setting.
One year of experience with Health Plan EDI processes.
Proficient in Microsoft business applications.
Experience in collecting, organizing, analyzing, and presenting data.
Solid understanding of EDI ANSI X12 transactions.

Qualifications (Preferred)

Preferred

Experience with Epic Tapestry claims processing system.
Demonstrated attention to detail and process flows

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

We are University of Utah Health. Employment.utah.edu

Immediately Hiring

Physical Requirements

Color Determination, Listening, Manual Dexterity, Near Vision, Sitting, Speaking

Multi-lingual Candidates Welcomed

EEO Statement

University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.

All qualified individuals are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.

University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Affluent Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.

To request a reasonable accommodation for a disability, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 801-581-6500. If you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity (OEO). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at: www.utah.edu/nondiscrimination/ Online reports may be submitted at oeo.utah.edu.

The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Hospitals and Clinics Human Resources at (801) 581-6500 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or Hospitals and Clinics Human Resources at (801) 581-6500 if you have questions regarding the post-retirement rules.

This position may require the successful completion of a criminal background check and/or drug screen.

Requisition Number: 85270

Reg/Temp: Regular

Employment Type: Full-Time

Shift: Day

Work Schedule: 8-5

Clinical/Non-Clinical Status: Non-Clinical

Location Name: University of Utah Health Plans

Workplace Set Up: Hybrid

City: Murray

State: UT

Department: UIP CST 01H UUHP SYSTEMS DEPT