Anaylst, Data Integration EDI

$62,300 - $80,000/Yr

Evolent Health - Richmond, VA

Full-time - Entry Level

Richmond, VA

Professional, Scientific, and Technical Services

About the position

The EDI Analyst at Evolent Health plays a crucial role in analyzing, monitoring, and resolving EDI X12 transaction data issues. This position focuses on process optimization to enhance the EDI Gateway and organizational needs, ensuring effective communication and collaboration across various teams. The analyst will utilize tools such as Edifecs Healthcare Suite, SQL, and PowerBI to support operational tasks and improve data exchange processes.

Responsibilities

• Monitor, execute, and remediate daily EDI Gateway operational processes related to enterprise-wide production interfaces.
• Provide EDI analysis expertise on 837 Claims, 835 Payments, and other X12 EDI data exchanges.
• Assist with data issues and ticket triage supporting escalation on EDI transactions.
• Help operationalize tasks by defining procedures and creating SOPs.
• Communicate vital information with stakeholders regarding daily operational tasks and monitored processes.
• Monitor client inbound and outbound EDI data file extracts and remediate failures in Edifecs TM.
• Coordinate multi-team processes within Evolent business units and create process documentation in Confluence.

Requirements

• Bachelor's degree or equivalent combination of education and experience.
• 1 or more years of experience with EDI data exchanges like 837, 835, 270, 271, 276, 277, 999, and 834 Enrollment.
• Substantial knowledge of Claims, Authorization, and Eligibility along with Microsoft Suite applications.
• Strong interpersonal and communication skills with experience working with stakeholders.
• Ability to apply problem-solving and critical thinking skills in ambiguous situations.
• Knowledge of Healthcare Standards and CMS Rules and regulations is preferred.
• Experience developing and documenting business-related SOPs with minimal oversight is preferred.

Nice-to-haves

• Knowledge of ICD 10 and HCPCS codes fundamentals and advanced skills.
• Experience with troubleshooting EDI errors.

Benefits

• Comprehensive health insurance benefits
• Bonus component based on performance factors