EDI Analyst

  • location: Boston, MA
  • type: Contract
  • salary: $35 - $41 per hour
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job description

EDI Analyst

job summary:






Our client is currently seeking an EDI Analyst for 6+ month contract opportunity located in Boston, MA.





 
location: Boston, Massachusetts
job type: Contract
salary: $35 - 41 per hour
work hours: 8am to 5pm
education: Bachelors
 
responsibilities:
MAJOR PURPOSE

The EDI Analyst supports inbound and outbound EDI submissions of HIPAA compliant transactions, including 270/271, 276/277, 837I, 837P, 835 and 999/TA1. Provides ongoing support to EDI testing/research and for new initiatives. Reporting to the Manager of EDI Trading Partner Testing, this role is integral to EDI functions.

JOB SUMMARY

- Apply systems analysis techniques to identify and determine root cause of electronic file submission failures for the following transaction sets utilizing industry standards (Washington Publications Implementation Guides, Companion Guides, American National Standards Institute X12):

o Health Care Benefit/Eligibility Inquiry / Response (270/271)

o Health Care Claim: Institutional and Professional (837)

o Health Care Claim Status Request / Response (276/277)

o HIPAA Implementation Acknowledgment for Health Care Insurance (999/TA1)

o Health Care Claim Payment/Advice (835)

- Outreach to Trading Partners with results of analysis and resolutions of the EDI transaction sets. Provide direction to the provider on how to resolve or make computer systems changes to correct the file. Handles communications with Trading Partners for EDI transaction set-up and ongoing maintenance and support.

- Thoroughly documents EDI transaction issues and communicates critical issues to the Provider Services leadership team. Utilizes a support console to track testing status and results; makes notes of errors and resolutions; and log the type of, reason for, and results of communications with the Trading Partners.

- During testing implementations, assists in the technical design and workflow of the Trading Partner testing process.

- Works with MMIS Information Technology development staff to resolve Trading Partner testing errors as swiftly as possible and make recommendations on system modifications.

- Maintains compliance with contract requirements related to EDI Trading Partner Testing. Participates in ongoing communication between the EDI team, the Contact Center, and Provider Relations staff to optimize customer service to the provider community.

- Perform other duties as assigned by management

 
qualifications:
EDUCATION REQUIRED

- High school diploma; Associate's Degree or Bachelor's Degree from an accredited college or university is preferred, or the equivalent combination of education and experience.

 
skills: REQUIRED KSAS

- A minimum of 5 years of experience.

- Must be self-motivated and able to work independently.

- Strong written and oral communication skills. Ability to communicate clearly.

- Strong organizational and administrative skills, attention to detail, and the ability to follow through are essential.

- Excellent critical thinking skills.

- Ability to effectively build positive and production relationships and achieve business results.

- Exhibits high standards of ethical conduct.

- Maintains confidentiality of all provider and member information and company documents.

- Knowledge of and experience working with HIPAA transactions, specifically 270/271, 276/271, 837I, 837P, 835 and 999/TA1.

- Testing experience.

PREFERRED KSAS

- Experience with State contracts is a plus.

- Experience working with EDI Testing Trading Partners preferred.

- Experience working with X12 and XML file formats preferred.

- Experience documenting policies and procedures preferred.


Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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