Remote EDI Claims Analyst - SQL & QNXT Expert

HJSRLLC

Phoenix (AZ)

Remote

USD 90,000 - 120,000

Full time

6 days ago

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Job summary

HJ Staffing is seeking an EDI Technical Analyst (Claims) to support, analyze, test, and maintain EDI transactions, integrations, and data exchange processes for healthcare claims operations. In this role, you will partner with business and technical teams to troubleshoot production issues, develop technical documentation, create data mappings, and ensure successful data exchange between trading partners.

The ideal candidate combines strong analytical skills, EDI expertise, SQL proficiency,

Qualifications

3 years of experience in computer technology and/or information systems.
2 years of experience in data analysis, data management and integration, data extraction, and reporting.
2 years of healthcare EDI experience.
Hands-on experience with 270/271, 834, 835, and 837 EDI transactions.
Recent, hands-on QNXT experience within a healthcare payer environment is strongly preferred.
Hands-on experience with Microsoft SQL Server and writing SQL queries for production support, testing, troubleshooting, and reporting.
Experience with data mapping, flat-file analysis, EDI file testing, and production support.

Responsibilities

Production Support: Support, troubleshoot, and resolve EDI production issues related to claims and trading partner transactions; participate in on-call support rotations.
Data Analysis & Mapping: Analyze, map, and validate healthcare data exchanges including 270/271, 834, 835, and 837 transactions.
SQL & Monitoring: Write and maintain SQL queries for production support, reporting, testing, and data validation. Utilize Splunk, App Insights, SOAP UI, and Postman to monitor and validate system performance.
Testing & Documentation: Create and execute test plans, process test files, document results, and resolve defects. Develop technical specifications, mapping documents, and process flows.
Integrations: Support API integrations, ETL processes, and enterprise data exchange initiatives while developing dashboards to monitor data quality.
Compliance: Maintain strict compliance with HIPAA requirements and healthcare EDI standards including TR3, CAQH CORE, and Blue Exchange guidelines.