EDI Analyst

NexSolv is seeking an EDI Systems Analyst for our direct client. Share your updated resume if you are interested in this position:

• Provide data analysis, transactional support, error detection, resolution, and all related services for the successful Electronic Data Interchange (EDI) Operations of the Exchange.
• Perform HBX System Error analysis.
• Validate 1095-A and 1095-B files, and reconcile 8001 transactions.
• Analyze EDI files sent to and received from Carriers, Managed Care Organizations (MCO), and other entities, and identify errors and root causes for EDI file rejections.
• Analyze the EDI 999 files from the Carriers and MCOs and perform root cause analysis for exceptions and assist with resolving any data issues.
• A minimum of four (4) years of experience with the Health Exchange marketplace EDI solutions.
• A minimum of four (4) years of experience creating EDI X12 files for transaction sets such as 834, 999, and TA1.
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• Preferred Qualifications
• A minimum of six (6) years of experience with EDI validation tools such as Edifecs, WTX, EDI X12 files, or equivalent.
• A minimum of six (6) years of experience with EDI transaction sets such as 834, 820, 999, and TA1, SOA, EDI, or EAI applications.
• A minimum of two (2) years of hands-on experience writing complex SQL scripts.
• Knowledge of the Affordable Care Act (ACA) eligibility rules for Medicaid and Qualified Health Plans.
• Experience with or knowledge of Medicaid 8001 file processing or any other inter-agency transactional file processing.
• In-depth understanding of EDI 834 enrollment transactions, including Adds, Changes, Terminations, Cancellations, and error processing.