Experian EDI Analyst ( Healthcare, X12, 270, 271, SQL, benefits, eligibilty experience required ) in United States
At Experian Health, our employees have the opportunity to shape more than products – they shape the future of U.S. healthcare. Experian Health is a pioneer for innovations leading the way in revenue cycle management, identity management, patient engagement, and care management for hospitals, physician groups, labs, pharmacies and other risk-bearing entities. Our success relies on people who are given the freedom to imagine new frontiers in the rapidly changing healthcare space and push the boundaries of innovation. Help us realize our vision of applying data for good and changing the healthcare landscape for the better – for all of us.
The EDI Analyst will support Transaction Content value add application development and implementation by applying a combination of business and technical knowledge in healthcare revenue cycle management software and processes. This position will have responsibility to ascertain, resolve and direct content issues arising out of multiple avenues and channels; including but not limited to the connectivity, design, performance, requirements gathering, implementation, testing and support processes and interventions.
• Establish, build and strengthen internal relationships with Development, Customer Support and Implementation and leverage those relationships to resolve transaction content, development and connectivity issues. • Establish, build and strengthen external relationships with clients to understand needs, requirements, demands, and issues. Effectively communicate with clients on issue resolution activities and alternatives. • Triage content issues from Implementation, Support, Development and other avenues on a project basis, working collaboratively with teams that include Customer Support, Patient Estimates, Bad Plan Code, Implementation and Payer teams • Work collaboratively with teams to identify the issue, conduct research, develop plan for resolution, and engage appropriate internal and external staff to execute the solution. • Work collaboratively to make technical judgments based upon understanding of the business process and client needs whereby a design change or modification should (or needs to be) changed. • Uses product knowledge, technical expertise, and business knowledge in revenue cycle management processes to provide an appropriate strategic vision for decision-making, triaging and escalation process. • In-depth analysis of past/present eligibility information in text and builds comparable data models. • Monitor on-going industry changes for data improvements. • Proactively look for possible issues or improvements with valid response data • Develop optimal search strategies for utilizing EDI and web based transactions. • Research payer products, subsidiary relationships and delivery networks to create value-added content for providers • Support Developers in tool creation to assist other areas • Support inquiries from Sales and Customer Support on content related questions and monitor areas for improvement. • Manage content projects by tracking specifications and delivery dates and ensure operational implementation with initial customers. • Monitor daily audit operations activity to detect trends and pinpoint problems in content. • Perform basic Quality Assurance analysis on content related projects. • Assist in running KPI reports and analysis for trending • Evaluate customer business problem and develop solution to meet requirements from concept through final implementation. Including problem definition, evaluation of requirements, coordination of teams to execute, implementation of systems
REQUIREMENTS: • Bachelor’s degree in Business, Computer Science, or other related field preferred. •At least 5 years prior business analyst, implementation, or client/payer-side (payer or hospital/health system) experience in healthcare revenue cycle management software and technology • Equivalent combination of education and experience may be considered •Healthcare eligibility benefits experience (hospital and physician) required • Understanding of HL7 and X12 message/file formats and transactions required • Effective communication and relationship building skills • Strong Project Management and organizational skills • Effective negotiation skills • Self-motivated, autonomous, driven to achieve excellence •*Advanced SQL query skills / experience * • EcareNext/PE/Chaining familiarity preferred • Epic, Cerner, Meditech, McKesson background preferred
/Experian is an Equal Opportunity Employer. Anyone needing accommodation to complete the interview process should notify the talent acquisition partner. The word "Experian" is a registered trademark in the EU and other countries and is owned by Experian Ltd. and/or its associated companies. EOE including Disability/Veterans
/ / /
Title: EDI Analyst ( Healthcare, X12, 270, 271, SQL, benefits, eligibilty experience required )
Location: United States
Requisition ID: 204434
- Experian Jobs