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EDI Analyst
100% Remote
Corewell Health equipment will be provided. No expenses, no holidays. Experience with Facets, OnBase, and server/network configuration is also a plus. The candidate must have experience with healthcare EDI and must be able to communicate professionally in both verbal and written formats with internal and external customers.
Job Summary
Provides support for the EDI Operations department by interfacing with internal and external customers, including business analysts, software developers, project managers, trading partners, and software vendors. This role is responsible for managing a range of EDI transactions, including enrollment, claims, financial, and eligibility transactions using ANSI X12 HIPAA-compliant formats. Provides technical support for the implementation of EDI connections with external parties, responds to inquiries related to EDI transactions, conducts analysis of EDI transactions, and provides issue resolution when necessary. Handles multiple enhancement requests and projects.
Essential Functions
- Demonstrate knowledge of EDI standard formats and communicate complex data exchange concepts to internal and external parties.
- Interface professionally with various internal and external customers, including Operations, Sales, Marketing, IS, and Trading Partners, to understand and process work requests.
- Responsible for the implementation of electronic data interchange connections between Priority Health and external parties.
- Support ongoing implementations in post-production, including error identification/resolution, continuous improvement, and proactive communication with trading partners and providers to reduce/prevent errors.
- Verify and monitor EDI processes, troubleshoot and resolve EDI-related issues, develop and maintain procedural documentation, and follow up comprehensively with all stakeholders during the issue remediation process to ensure delays are minimized and the process runs smoothly.
- Assist in defining application enhancements and upgrades.
- Perform application configuration, mapping, and monitoring of EDI transactions and processes.
- Support application testing efforts by performing user acceptance testing (UAT) and assisting in defect resolution.
- Provide on-call support as necessary.
Qualifications
- Required: Associate's Degree (or equivalent education and experience)
- Preferred: Bachelor's Degree
- 2 years of relevant experience analyzing EDI data to identify content and/or formatting issues
- 2 years of relevant experience using SQL queries to retrieve and/or display data
- 2 years of relevant experience reading, analyzing, formatting, and translating EDI data
- 2 years of relevant experience implementing EDI setup and mapping
- 2 years of relevant experience in the healthcare industry (Preferred)
- 2 years of relevant experience with Facets software or a similar healthcare enrollment/claims management software system (Preferred)
Once the contractor begins their assignment, they are responsible for submitting their time through the appropriate portal by Mondays at 11:59 a.m. (Fieldglass for Non-DS Business Unit / Planview for DS Business Unit). The supplier is responsible for training contractors in Fieldglass, while hiring managers are responsible for training in Planview. (Once approved, Planview timesheets integrate into Fieldglass for payment.) Fieldglass is our platform for invoicing and payments, so if timesheets are not completed with manager approval, it will impact your agency's payment from Corewell Health. Contractors are responsible for following up with their managers for approval. |
