EDI Analyst

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 pro-active communication with the trading partners and providers to reduce/prevent errors.

* Verify and monitor EDI processes. Troubleshoot and resolve EDI related issues. Develop and maintain procedural documentation. Follow-up comprehensively with all stakeholders during issue remediation process to assure that 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 effort by performing user acceptance testing (UAT) and assisting in defect resolution.

* Provide on-call support as necessary.

Qualifications

Required

* Associate's Degree or equivalent

* 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/translating EDI data

* 2 years of relevant experience Implementing EDI setup and mapping

Preferred

* Bachelor's Degree

* 2 years of relevant experience in the healthcare industry

* 2 years of relevant experience with Facets software or a similar healthcare enrollment/claims management software system

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope.

Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

* Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

* On-demand pay program powered by Payactiv

* Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

* Optional identity theft protection, home and auto insurance

* Traditional and Roth retirement options with service contribution and match savings

* Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Priority Health - 1239 E Beltline Ave NE - Grand Rapids

Department Name

EDI - PH Managed Benefits

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8:00 a.m.

- 5:00 p.m.

Days Worked

Monday - Friday

Weekend Frequency

N/A

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and…