Analyst, Data Exchange (Medical, Dental & Vision)
Skills
- Strong knowledge of healthcare EDI transactions (e.g., 834, 837, 835).
- Experience with healthcare claim adjudication processes for medical, dental, and vision.
- Familiarity with EDI SNIP validations and tools like EDIFECS.
- Proficiency with file transfer protocols such as FTP, SFTP, and FTPS.
- Understanding of HIPAA compliance and healthcare regulations.
- Proficiency in SQL, Excel, JSON preferred.
- Analytical, problem-solving, and critical thinking skills.
- Strong communication and collaboration abilities.
Responsibilities
- Design and maintain data mappings and transformations for healthcare data files.
- Collaborate with internal teams and external partners to define data exchange requirements.
- Develop and implement data validation rules to ensure data accuracy and completeness.
- Monitor system status and data exchange management to identify abnormalities.
- Provide technical support and troubleshoot data exchange issues.
- Document data exchange processes and configurations.
- Identify opportunities to optimize and automate data exchange processes.
- Generate reports on data exchange performance and analyze data trends.
- Participate in projects involving vendor changes, client migrations, and add-ons.
- Ensure adherence to company policies and report noncompliance.
Education
- Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or related field preferred.
- Equivalent work experience may be considered.
Benefits
- Remote work flexibility.
- Opportunity to work with cutting-edge health technology solutions.
- Diverse and inclusive workplace culture.
- Equal employment opportunity employer with commitment to non-discrimination.
Average salary estimate
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