Description

You will manage data analysis, transactional support, and error resolution for Electronic Data Interchange (EDI) operations.

Responsibilities

• Perform 8001 Medicaid transaction file analysis, validations, and reconciliation with 1095-A and 1095-B files.
• Analyze EDI files from Carriers and Managed Care Organizations (MCO) to identify root causes for file rejections.
• Resolve data issues involving Master Data Management (MDM), Master Person Identifier (MPI), and HBX System Errors.
• Execute data changes and technical solutions by accessing HBX databases to fix consumer or system-reported errors.
• Coordinate with development, business, and testing teams to analyze, fix, and transmit daily EDI files.

Required Skills

• 4+ years of experience with Health Exchange marketplace EDI solutions.
• 4+ years of experience creating EDI X12 files for transaction sets including 834, 999, and TA1.
• 4+ years of experience reviewing technical documentation, such as companion and implementation guides for Healthcare EDI formats 834 and 999.
• 4+ years of experience analyzing, testing, and providing data solutions for healthcare marketplaces.
• 2+ years of experience working with SQL databases and queries.
• Proven ability to translate business requirements into technical requirements and EDI data fixes.
• Strong analytical skills to perform root cause analysis for EDI 999 file exceptions.
• Ability to manage multiple critical priorities and tight deadlines.

Preferred Skills

• Excellent communication skills for cross-functional coordination.

Key Skills

Education

Any Graduate