Healthcare EDI Encounter

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://jobrealtime.com/jobs/technology/healthcare-edi-encounter_i3855