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Description:


Description: 834 EDI Analyst (1 Opening) / 837 EDI Analysts (1 Opening)
Location: Linthicum, MD
Primary development role related to the eligibility and claims adjudication system and internal processes.
Responsible for importing data feeds into Oracle database or exporting data from the database into appropriate EDI formats to support member 'eligibility' and 'encounter' business processes.
Responsible for developing and testing HIPAA EDI 5010 X12 mapping formats (834,837,277,999) as well as industry standard and custom formats using ETL tools.
Review, evaluate, design and implement systems processes to ensure data integrity is consistently maintained.
Coordinate with external clients and internal operations depts. to ensure effectual setup and design of data formatting and flow for new client implementations.
Own and project manage the development of ongoing implementations start to finish from client meeting and companion guide, through internal testing process and development and into production with documentation.
Provides ad-hoc data/reports to clients or internal departments per request.
Produce comprehensive documentation of all developed software & repositories.
Automation of routine processes with appropriate monitoring controls.
Other duties as assigned.

Qualifications:
Education:
Bachelor's Degree in Computer Science or related field.
Experience: Minimum of 3-5 years relevant work experience and experience in managed health care
Competencies:
Prior experience in EDI Programmer/Analyst role.
MUST HAVE DETAILED EXPERIENCE WITH 834 or 837
Accuracy, attention to details.
SQL Server database (2012)
SQL Server Integration Services (SSIS)
SQL Server Reporting Services (SSRS)
Experience in implementation of control and reconciliation reports.
Advanced knowledge and understanding of relational database environments.
2 Must have Previous experience in a healthcare claims adjudication system. and strong healthcare background
Experience developing encounter and eligibility transactions set maps and processes in HIPAA EDI 5010 X12.
Experience writing PL/SQL queries in Oracle or SQL Server.
Experience with an ETL and data mapping tools.
Experience in structured, data-driven, functional logic programming
Team oriented with the ability to work effectively across functional areas of the company.
Excellent analytical, problem resolution and people skills.
Ability to deliver quality results under tight deadlines.

Last updated on Nov 7, 2016

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