EDI Business analyst (Healthcare domain)---REMOTE

Primary duties and responsibilities

• Support Product Owners, Business Owners and Leads, using technical and analytical expertise along with EDI and Claims processing knowledge to support the service operations teams.
• Interface and communicate at varying levels of the organization, including direct communication with cross-functional areas across the company; coordination with Operations, SMEs and IT teams will be key to success.
• Drive requirements for claim intake rules, provider and member selection logic and liaise with Agile team(s).
• Create, update, and maintain all documentation surrounding EDI and Intake rules such as requirements, process diagrams, solution diagrams, etc.
• Perform analysis of EDI and Claims intake rejections stemming from internal as well as stakeholder inquiries including provider calls while also tracking and executing solutions.
• Subject Matter Expertise on EDI transactions (837s, 277, 835, 275, etc.) along with technical skillset to build ad hoc queries, data transformations, and data analysis for research and troubleshooting.
• User Acceptance Test logic changes and enhancements.

Required Qualifications

• 2+ years working on EDI transactions including but not limited to 837s, 277s, 999s, 275s, 835s, etc.
• 2+ years of project management experience, preferably in EDI and Claims operations.
• 5+ years of data interpretation and analysis experience
• 2+ years of demonstrated leadership.
• 3+ years querying large datasets using SQL, SAS, or other data tools.
• Proficient in Word, PowerPoint, Excel
• Initiative-taker with the ability to work in

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