Overview
Skills
Job Details
Absolutely no third parties please !
Our direct client, a non-profit organization, is seeking a Junior Healthcare EDI Business Analyst
First 4-6 months is training, must be in the office 5x per week. After training is completed, hybrid situation with more flexibility to work remote.
You will support our client with day to day EDI claim file loading and error review. We are seeking a passionate, results-oriented Business Analyst in the healthcare payer domain with specific knowledge around Medicare eligibility, EDI, 834, 835 and 837 (dental).
Responsibilities:
Support daily claims files that must be uploaded into QNXT. Review claims rejections, 834 eligibility files for errors, outbound extracts for vendor eligibility, reconciliation of files for Medicare eligibility etc-
Serves as a liaison between the business programs community and IT organization to create business requirements and assist with technical solutions to meet project needs.
Analyze and document business requirements and processes; use and promote industry standard analysis techniques, such as data flow modeling, use-case analysis, workflow analysis, business process mapping.
Break down high level information gathered into details including sources of data, data types, users, user types, interface components, interface navigation needs, reporting needs, and administrative system needs.
Produces business design document based on product and solution requirements.
with teams to ensure timely resolution and delivery of high-quality products and solutions.
Partner with stakeholders on requirements prioritization, solution approach and alternatives, and manage requirements changes to ensure developed solution conforms to business needs. This position is a fulltime/direct FTE opportunity with our Healthcare client who is offering a generous salary and benefits package. For the first 4-6 months during training, this position will be onsite 5x per week in Elkridge MD. Once training is completed, this position can move into a hybrid telework opportunity.
Degree is preferred, not required.
2+ years as a Business Analyst a Healthcare Payor Environment.
Familiar with claims administration systems and terminology - working knowledge of Eligibility and Enrollments, Administration of Plans, Benefits, Claims, Accumulators, and Provider Payments
Experience with SFTP, EDI X12 transactions 834, 835, 837 is required
Must be able to communicate effectively with internal and external stakeholders
Ability to create complex SQL queries that includes but not limited to extract data, update and insert functions
Proficient in Microsoft Office including Outlook, Excel, Visio, PowerPoint and Word.
Big Plus: QNXT and Medicare
Apply today for immediate consideration. I look forward to hearing from you.