Job Description
Terms of Employment
- W2 Contract-to-Hire, 6 Months
- This position is predominately remote. With that said, candidates should be based in Maryland, Washington, DC, Virginia, or West Virginia to consider onsite work for “All Hands” meetings up to once per quarter.
Overview
Our client is seeking an EDI Analyst to perform initial triage and full incident life cycle monitoring in support of Health Insurance Plans. This position requires technical and analytical skills with a focus on incident definition, isolation, and resolution. I t requires deep knowledge of EDI 837 Claims analysis, 999 errors, and SQL queries. Week-to-week responsibilities include:
- Work with various members of the team to provide Tier 1 technical support to plans - involving initial triaging of reported incidents with the applications with a focus on data collection and prior incident pattern analysis.
- Work closely with Consultants to ensure smooth communication and prompt follow-up on logged incidents with the applications.
- Provide some basic technical support for tenant plans, running queries, and making recommendations on changes to the tenant plans interfaces to improve the overall customer experience.
- Create and run performance monitoring reports for end customers including SLA tracking reports.
- Manipulation of 837/835 EDI/XML files to generate a wide variety of valid claims
- Write complex SQL queries for retrieval of required from multi-database environment.
- Accountable for specific deliverables as defined by the Plan Consultants and leadership.
- Document incident resolutions, escalations, and closures within the CareFirst Incident tracking tool.
- Document system monitoring design, implementation, as well as SOPs for various support teams.
- Monitor applications through tools like Dynatrace and Jenkins.
Required Skills & Experience
- Bachelor’s degree and 5+ years of experience in EDI analysis – OR – High School diploma and 9+ years of experience in EDI analysis.
- Detailed knowledge of 837 EDI format including all segments and loops.
- Ability to manipulate 837 EDI/XML files to generate a wide variety of valid claims.
- Experience using SQL to run queries.
- Experience using application monitoring tools such as Dynatrace, Jenkins, or similar.
- Experience in incident management using ticketing systems such as ServiceNow, OneStop, or similar.
- In-depth knowledge of Claim Adjudication processes.
- Excellent written and verbal communication skills with the ability to interact with customers and internal teams with a goal of issue resolution.
Preferred Skills & Experience
- Experience with 835 EDI.
- Experience with Blue Plans.
- Some exposure to Object Oriented languages.
- Strong knowledge of Oracle database.
Job Tags
Contract work,