EDI Data Analyst
Linthicum Heights, MD
RESPONSIBILITIES:Kforce has a client in Linthicum, Maryland (MD) seeking an EDI Data Analyst to join their team.Key functions: Primary analytical role related to the claims adjudication system and internal processes Responsible for importing, validating and reporting data into database or exporting data from the database into appropriate EDI formats to support business processes Responsible for developing and testing HIPAA EDI 5010 X12 mapping formats (835, 837, 277, 999) as well as industry standard and custom formats using ETL tools Manage day-to-day production file monitoring for complex 837 encounter file processing including troubleshooting and error investigation Coordinate with external clients and internal operations depts. to ensure effectual setup and design of data formatting and flow for new client implementations 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 Provide assistance and training in encounter data processing with project team Design and execute EDI test plans; Provide timely communication amongst clients on a daily/weekly/monthly basis as well as ad-hocCRITICAL SKILLS: Bachelor's degree in Computer Science or related position Min of 3-5yrs of relevant work background in managed health care is a must Prior background in an EDI Analyst role in a healthcare claims adjudication system/environment is a must Comprehensive knowledge of HIPAA EDI 5010 X12 837, 835, 277 and 999 files, including detailed understanding of all relevant loops and file structures is a must Knowledge of reporting encounter claims and encounter resubmission processes Communication and coordination skills: Ability to lead development efforts and client meetings Ability to provide critical analysis on client needs as well as attention to info and accurately documenting processes Background building encounter transactions set maps and processes in HIPAA EDI 5010 X12 based on business needs is a must Ability in reporting/analysis of resubmissions of 837 encounter data Ability to work with multiple implementation partners (external and internal) to support submission of 837 encounter/claim data for processing and storage Background in implementation of control and reconciliation reports Knowledge and understanding of relational database environments SQL Server database (2012) knowledge is a plus Background writing SQL queries in SQL Server Background with an ETL and data mapping tools Background in structured, data-driven, functional logic programming Team oriented with the ability to work efficiently across functional areas of the company Excellent analytical, problem resolution and interpersonal skills Ability to deliver quality results under aggressive deadlinesKforce is an Equal Opportunity/Affirmative Action Employer. All applicants who are qualified will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
September 12 on Professional Diversity Network