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EDI Support Analyst

San Mateo, CA
Title:  EDI Support Analyst
Location: San Mateo, CA

Full-Time
 
Job Description:
Responsible for various EDI areas including Enrollment, Claim file uploads and Incoming 834 Healthcare eligibility files.  Supports EDI staff for enrollment, claims file loading and process quality. Manage existing/new health plan enrollment uploads for HMO and PPO direct product categories. Maintain relationships with Health Plans, internal Business teams, Developers and Operations.  
Create and update Electronic transaction set activities for Enrollment
Participate in workgroups when there are interdepartmental projects that affect or involve EDI (claims, encounters, ERA)
Assist other departments with EDI related portions of their projects
Maintain Relationship with Health plans and Clearinghouses
Troubleshooting enrollment file issues - Format issues, file or report delivery issues
Enabling staging and loading of the enrollment files
Establishing connectivity with new trading partners/Health plans including testing file transfers and format
Project related work such as initiating new HIPAA mandated transactions sets (834), initiation of new standard code sets, code set upgrades
Other EDI activities including providing files for testing; system upgrades, research duplicate and missing files
 
Experience and skills:
-   Knowledge of the structure and functions of the standard X12 ANSI file formats; 837P, 837I, 835, 834, 277, 999
-   Experience working with ANSI and flat file formats and mapping data elements to other applications
-   5+ years of experience in software applications support in healthcare and healthcare information systems development and support
-   Experience using project tools and processes to create work flows, test cases, and document test results
-   Experience working with end users, to determine business needs and requirements and document them in a standard format
-   Excellent written, verbal and interpersonal communication skills
-   Ability to exercise good judgment, prioritize multiple tasks and problem solve under pressure of deadlines and resource constraints
-   Strong analytical and problem solving skills
-   Good knowledge of MS Access and Excel
 
Education: BS. Computer Science, MIS, Health care preferred
 
 
 
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