Anaylst, Data Integration EDI - Evolent Health
Lincoln, NE
About the Job
Your Future Evolves Here
Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.
What You’ll Be Doing:
The EDI Analyst at Evolent will serve as a key technical expert to analyze, monitor and remediate EDI X12 Transaction data issues, working with tools such as but not limited to the following: Edifecs Healthcare Suite, Edifecs Transaction Manager, Edifecs Specbuilder, SQL, PowerBI, Microsoft suite/tools (e.g. Office, PowerBI, Teams), Atlassian products (e.g. Confluence, JIRA) and several internal built applications etc. Continual focus working on developing process optimization solutions to better meet the EDI Gateway and organizational needs.
Collaboration Opportunities :
This position serves as a technical operational point-of-contact for the mentioned functional areas and collaborating with several other teams and/or departments to further operationalize tasks which may require building new processes, solution, documentation etc. along with communicating vital information to key stakeholders related to status of monitored processes. Assisting with Tier 2 and Tier 3 internal support teams to remediate complex data issues.
What You Will Be Doing:
+ Monitor, Execute and Remediation of Daily EDI Gateway Operational Processes related to enterprise-wide production interfaces with continuous focus on process improvement.
+ EDI analysis expertise on 837 Claims, 835 Payments corrections required with good understanding of X12 EDI Data exchanges like 837, 835, 270, 271, 276, 277, 999 and 834 Enrollment
+ Working on data issues or other initiatives related to both Data Operations and Electronic Data Interchange (EDI) focus areas and Tickets triage supporting escalation on EDI transactions.
+ Assisting other teams and/or departments to help operationalize tasks _(e.g. defining procedures & creating SOPs_ ) that may require additional support not currently present.
+ Communicating vital information with internal and external stakeholders related to daily operational tasks and/or status of monitored processes using PowerBI/Edifecs TM.
+ Monitor various client inbound & outbound EDI data file extract creations and remediate failures in Edifecs TM as they arise along with update operational process tickets and request status updates to processes as applicable.
+ Coordinate multiteam faceted processes within Evolent business units and create process documentation in Confluence for other team members to reference for future trainings or new hire.
Qualifications Required and Preferred:
+ Bachelor's degree or equivalent combination of education and experience
+ 1 or more years of experience with EDI Data exchanges like 837, 835, 270, 271, 276, 277, 999 and 834 Enrollment , ICD 10, HCPCS codes fundamentals and advanced skills _(e.g. Claims correction, 835 Payment corrections, troubleshooting EDI errors)_
+ Substantial knowledge of Claims, Authorization and Eligibility and Claims status information along with Microsoft Suite applications ( _e.g. Word, Excel_ ) and their functions
+ Strong interpersonal and communication skills, with experience working directly with internal and external stakeholders
+ Strong ability to apply problem solving and critical thinking skills with experience succeeding in ambiguous situations and solution design/implementation
+ Knowledge of Healthcare Standards and CMS Rules and regulations is preferred
+ Experience developing, refining and documenting business related SOPs with minimal oversight is preferred
Technical Requirements:
We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.
The expected base salary/wage range for this position is $62,300 - 80,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.
Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
For more insights about Evolent Health, click on Life At Evolent (https://www.evolent.com/) to learn more!
Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.
What You’ll Be Doing:
The EDI Analyst at Evolent will serve as a key technical expert to analyze, monitor and remediate EDI X12 Transaction data issues, working with tools such as but not limited to the following: Edifecs Healthcare Suite, Edifecs Transaction Manager, Edifecs Specbuilder, SQL, PowerBI, Microsoft suite/tools (e.g. Office, PowerBI, Teams), Atlassian products (e.g. Confluence, JIRA) and several internal built applications etc. Continual focus working on developing process optimization solutions to better meet the EDI Gateway and organizational needs.
Collaboration Opportunities :
This position serves as a technical operational point-of-contact for the mentioned functional areas and collaborating with several other teams and/or departments to further operationalize tasks which may require building new processes, solution, documentation etc. along with communicating vital information to key stakeholders related to status of monitored processes. Assisting with Tier 2 and Tier 3 internal support teams to remediate complex data issues.
What You Will Be Doing:
+ Monitor, Execute and Remediation of Daily EDI Gateway Operational Processes related to enterprise-wide production interfaces with continuous focus on process improvement.
+ EDI analysis expertise on 837 Claims, 835 Payments corrections required with good understanding of X12 EDI Data exchanges like 837, 835, 270, 271, 276, 277, 999 and 834 Enrollment
+ Working on data issues or other initiatives related to both Data Operations and Electronic Data Interchange (EDI) focus areas and Tickets triage supporting escalation on EDI transactions.
+ Assisting other teams and/or departments to help operationalize tasks _(e.g. defining procedures & creating SOPs_ ) that may require additional support not currently present.
+ Communicating vital information with internal and external stakeholders related to daily operational tasks and/or status of monitored processes using PowerBI/Edifecs TM.
+ Monitor various client inbound & outbound EDI data file extract creations and remediate failures in Edifecs TM as they arise along with update operational process tickets and request status updates to processes as applicable.
+ Coordinate multiteam faceted processes within Evolent business units and create process documentation in Confluence for other team members to reference for future trainings or new hire.
Qualifications Required and Preferred:
+ Bachelor's degree or equivalent combination of education and experience
+ 1 or more years of experience with EDI Data exchanges like 837, 835, 270, 271, 276, 277, 999 and 834 Enrollment , ICD 10, HCPCS codes fundamentals and advanced skills _(e.g. Claims correction, 835 Payment corrections, troubleshooting EDI errors)_
+ Substantial knowledge of Claims, Authorization and Eligibility and Claims status information along with Microsoft Suite applications ( _e.g. Word, Excel_ ) and their functions
+ Strong interpersonal and communication skills, with experience working directly with internal and external stakeholders
+ Strong ability to apply problem solving and critical thinking skills with experience succeeding in ambiguous situations and solution design/implementation
+ Knowledge of Healthcare Standards and CMS Rules and regulations is preferred
+ Experience developing, refining and documenting business related SOPs with minimal oversight is preferred
Technical Requirements:
We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.
The expected base salary/wage range for this position is $62,300 - 80,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.
Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
For more insights about Evolent Health, click on Life At Evolent (https://www.evolent.com/) to learn more!
Source : Evolent Health