Anaylst, Data Integration EDI

$62,300 - $80,000/Yr

Evolent Health - Olympia, WA

Full-time - Entry Level

Olympia, WA

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 requires technical expertise and collaboration with various teams to optimize processes and ensure effective data interchange. The analyst will focus on improving operational tasks related to EDI Gateway and will be responsible for communicating vital information to stakeholders while assisting with complex data issues.

Responsibilities

• Monitor, execute, and remediate daily EDI Gateway operational processes related to enterprise-wide production interfaces with a focus on process improvement.
• Provide EDI analysis expertise on 837 Claims, 835 Payments, and other X12 EDI data exchanges such as 270, 271, 276, 277, 999, and 834 Enrollment.
• Work on data issues and initiatives related to Data Operations and EDI, including ticket triage and escalation support for EDI transactions.
• Assist other teams in operationalizing tasks by defining procedures and creating SOPs.
• Communicate vital information with internal and external stakeholders regarding daily operational tasks and monitored processes using PowerBI/Edifecs TM.
• Monitor client inbound and outbound EDI data file extracts, remediate failures in Edifecs TM, and update operational process tickets as needed.
• Coordinate multi-team processes within Evolent business units and create process documentation in Confluence for training and reference.

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, as well as ICD 10 and HCPCS codes.
• Substantial knowledge of claims, authorization, eligibility, and claims status information, along with proficiency in Microsoft Suite applications (e.g., Word, Excel).
• Strong interpersonal and communication skills, with experience working directly with internal and external stakeholders.
• Ability to apply problem-solving and critical thinking skills in ambiguous situations and during solution design/implementation.
• Knowledge of healthcare standards and CMS rules and regulations is preferred.
• Experience in developing, refining, and documenting business-related SOPs with minimal oversight is preferred.

Nice-to-haves

• Knowledge of Healthcare Standards and CMS Rules and regulations is preferred.
• Experience developing, refining, and documenting business-related SOPs with minimal oversight is preferred.

Benefits

• Comprehensive health insurance benefits
• Bonus component based on pre-defined performance factors