EDI Analyst II

At MTM, we are not just colleagues; we are collaborators on a shared mission; communities without barriers. We have exciting opportunities to join our growing team where your work has a direct impact on the communities we serve. Our company culture is one of innovation, collaboration, and growth. If you are passionate, driven, and ready to join a team where your work will directly transform and shape our industry, then we want to talk to you!

The EDI Systems Analyst II will be accountable for guiding the actions of EDI experts by working closely with business units to analyze processes, analyze the business needs, and to provide solutions. The EDI Systems Analyst II role will solicit, define and manage EDI requirements for internally and externally developed projects and implementations in a team-oriented environment.

• Identify, document and educate MTM partners on client EDI requirements

• Identify, analyze and document business objectives and requirements by performing analysis and developing the necessary documentation to define, justify, launch and execute projects

• Define, create, and validate user stories necessary to achieve internal and external objectives

• Monitor, analyze, and ensure EDI compliance in the following subject areas:
  Member Eligibility, Encounter and Claims Data, Payment Remittance, Capitation, and Provider Data

• Manage and coordinate EDI deliverables to both internal and external stakeholders including but not limited to: EDI data files, accompanying reports, and required attestations

• Lead sessions for small to medium applications/projects or a few large applications/projects

• Validate EDI solutions meet both internal and external client needs

• Evaluate potential future client EDI requirements to support successful RFP and implementations processes

• Lead multi-team requirement gathering sessions, stakeholder interviews, group sessions, and user observations

• Act as a liaison between the business customer and the technology providers, both internally and externally

• Communicate relative feedback, level of effort, and return on investment to business users for project prioritization

• Responsible for making improvements of processes or workflows to enhance performance

• Partner with associated departments to ensure uniformity in data

  Remain informed on ever-changing information to ensure accuracy within business processes

• Partner with EDI developers to ensure solutions meet requirements

• High School Diploma or G.E.D equivalent

• Bachelor’s degree in technical or business disciplines with outlined experience, however, willing to accept equivalent field experience in lieu of degree

• Minimum 7 years of EDI technical or business work experience

• 3+ years of SQL experience

• 3+ years’ experience in software development methodologies including Agile and scrum processes

• 5+ years of working HIPAA X12 Standard Transactions

• 5+ years’ experience in eliciting/documenting business requirements using interviews, group facilitation, data/workflow/system analysis and business process documentation

• Previous experience collaborating with Business Users, Programmers, and Quality Assurance Testers in a corporate environment

• Comprehensive understanding of the common Health Care EDI transactions: 834, 837, 277U, 277CA, 835, 820, 270/271, 999

• Advanced knowledge of Health Care EDI subject areas and the ability to translate that into EDI requirements

• Ability to create SQL queries utilizing multiple tables and datasets to analyze and evaluate EDI data within a SQL database

• Accurately articulates technical specifications in a manner the normal business user can understand in both written and verbal form

• Ability to effectively work, demonstrate applications, and conduct presentations to all levels within the organization

• Demonstrates a positive attitude and flexibility in areas such as job duties and schedule in order to serve the business and operational goals

• Ability to translate business processes into workflows and system requirements

• Ability to manage multiple tasks and projects, and forge strong interpersonal relationships with both…