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EDI Health Care Data Expert - Little Rock, AR

Branch ID: 2278

Responsibilities

Define business requirements and acceptance criteria/test cases that support EDI Interfaces related to healthcare business platform including but not limited to 837, 834, 820, 835, 999, 277, 270 EDI transactions.

Define business requirements and acceptance criteria/test cases that support CMS, State and Vendor interfaces related to healthcare business platform.

Interact with new and current assigned clients and trading partners to capture and analyze requirements, mapping specifications and project objectives.

Mapping documents to and from various formats including but not limited to ANSI X12, XML, and flat file layouts.

Utilize a variety of software and platforms for statistical analysis and research concerning data

Create and standardize solutions and workflows.

Perform business analysis of identified process and software gaps or inefficiencies and develop plans to fill those gaps for internal business processes and for external clients.

Perform requirements review with external and internal stakeholders and obtain sign off from all required individuals.

Provide training to staff on new enhancements.

Identifies and documents system deficiencies and recommends solutions.

Ensures continuing operational quality by documenting fixes and enhancements.

Participates in the management of the sequencing of releases to meet business needs for enhancements, automations and implementations.

Identifies and documents system deficiencies and recommends solutions.


Requirements:
Required Extensive knowledge in health insurance third party administrator concepts for commercial, federal and state government plans to specifically support EDI Interfaces. Knowledge of health insurance, HMO and managed care principles including Medicaid and Medicare regulation. Knowledge of setting up communications for EDI transmissions using FTP, SFTP and real time API setups. Solid communication skills with working session facilitation. Strong time management and organizational skills. Excellent interpersonal, oral and written communication skills. Strong attention to detail and organization. Able to work independently and within a collaborative team environment with little guidance supervision. 2 plus years of computer skills, especially Word, Excel, Visio, Power Point, ticketing systems and SharePoint. 3 plus years of experience leading projects and cross functional teams in an automated production environment. Ability to successfully balance deadlines, projects, and day to day responsibilities. Preferred Associate or Bachelors degree preferred. Extensive experience in health insurance ANSI X12 transaction sets (i.e. 834, 837, 835, etc., XML and flat files). HMO Claims, Medicaid, Medicare and or managed care environment preferred. Certified Business Analyst is strongly preferred; equivalent demonstrated business analysis experience. Extensive experience with the System Design Life Cycle (SDLC). Superior root cause analysis skills, including corrective action planning and ability to provide documentation to support analysis. #LI-JS1

About Staffmark

The Company supports affirmative action and equal employment opportunity. The Company will provide equal employment in employment practices to all applicants for employment. Employment decisions shall be made without regard to any protected characteristic such as, but not limited to, race, color, religion, gender, age, disability, national origin, ancestry, citizen status, gender identity, sexual orientation, marital status, status in regard to public assistance, disabled veterans, recently separated veterans, Armed Forces service medal veterans and other protected veterans, genetic information and other legally protected classes. Furthermore, the Company is an E-Verify employer. Information provided on this application will not be used for any discriminatory purposes. The Company complies with all applicable federal, state and local non-discrimination laws and regulations. The Company will provide reasonable accommodations in the application or interviewing process. If you need a reasonable accommodation in the application or interviewing process, please contact us.

Job ID:
92605

Branch ID/Name:
2278

Location:
Little Rock, AR

Category:
Information Technology

Job Type:
Temporary Position
Industry
Information Technology

Posted:
12/06/2018

Apply for this Position

EDI Health Care Data Expert

City, State or Zip Code: Little Rock, AR

Position Type: Temporary Position

Date Posted: 12/06/2018