Required Skills :

EDI, Business Analyst

Job Description :

Title: Business Analyst with EDI Healthcare
Location: Charlotte NC (Remote)
Duration: 12 months
Job Description:
The Business Analyst EDI / Healthcare Specialist designs, implements, supports, and validates Provider Network (Physicians, Clinics, Pharmacies, etc.) and Client pricing constructs. This position includes monitoring of subscriber data feeds and related loads to assure systemic risks are identified and corrected, and audit and analysis of automated provider and client related pricing architecture and algorithms.
Success in this position includes assisting in the growth and maintenance of our software solutions by researching industry changes and data sets, analyzing data trends, identifying areas of opportunity, and aiding in the implementation of these enhancements. Ideal candidates should have a naturally analytical way of thinking, be able to quantitatively and qualitatively analyze information, be process oriented, and enjoy research and team collaborations.
The ideal candidate will demonstrate strong technical skills, will be familiar with the healthcare and health insurance industry, and will have experience interpreting volumes of technical information to define requirements for use during gap analysis and technical solution design.
Basic Qualifications:
Bachelor's degree or higher in business, healthcare administration, information systems, computer science, finance, accounting, mathematics, or a related field of study
Minimum of two (2) years of experience in business analysis including requirements gathering and specification documentation
Expertise in performing gap analysis, issue analysis, root cause assessment, and resolution planning
Understanding of professional and institutional claims processing and adjudication
1+ years of experience with HIPAA standards and regulatory guidelines and Electronic Data Interchange (EDI) transactions
Demonstrated knowledge of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDPD.0
Preferred Qualifications:
Strong planning, organizational, and time management skills
Superior analytical and conceptual thinking skills
Excellent verbal and written communication
Excellent documentation skills
Experience creating detailed reports and giving presentation
Ability to influence stakeholders and work closely with them to determine acceptable solutions
Competency in Microsoft applications including Word, Excel, and Outlook
Familiarity with relational databases (SQL)