Requirement details: Job title: Healthcare EDI Analyst Location: Albany, NY Duration: 12+ Months Healthcare EDI Encounter Analyst: ? HIPAA, 835, 837, 277, 999 Encounter Job Description: Scope and Purpose of Position: Primary job responsibility is to assume responsibility for the development, internal production and support process related and ensuring the timely and accurate processing of837 X12 Encounters files for Claims submitted by Beneficiaries maintained in the healthcare claims system and other EDI related files. Major Duties and Responsibilities: · 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. · Other duties as assigned. · Produce comprehensive documentation of all developed software & repositories. · Automation of routine processes with appropriate monitoring controls. · Other duties as assigned. · Diagnose problems with EDI processes, working with other technical and/or business resources as necessary · Develop EDI and batch process monitoring to track levels of activity, compiling and tracking metrics · Support the development of technical EDI implementation documentation, technical reports and payer companion guides · Expertise 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. · 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-hoc. · Experience in implementation of control and reconciliation reports. · Knowledge and understanding of relational database environments. · SQL Server database (2012) knowledge is a plus. · Experience writing SQL queries in SQL Server. · Familiar with SDLC and Agile methodologies · 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. · Ability to work independently with moderate supervision. · Working knowledge of other healthcare related EDI Transactions is a plus · Understanding of vision care insurance data is a plus.
Reference : Healthcare EDI Encounter jobs
source http://cvwing.com/jobs/technology/healthcare-edi-encounter_i5176
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