Health Care EDI Analyst

Description

ResponsibilitiesResponsible for performing data mapping using EDI software, supporting EDI software and the integration of EDI into application solutions, specification and design of logical business processes necessary to support standard based Healthcare transactions.Develops technical specifications for EDI application interfaces and provides technical support and business analysis during and after implementation of healthcare EDI applications and updated transaction formats.Responds to EDI inquiries and issues from internal organizations, trading partners, the state and CMS regarding healthcare transactions (enrollment, claims, encounter, status, payments) and clearinghouse activities.Conducts various analyses of EDI transactions and formats and is responsible for format mappings, processing procedures and other EDI documentation as well as various EDI reporting.Provides and communicates local expertise regarding standard concepts, practices and procedures of EDI formats (proprietary, NSF, ANSI, HIPAA).Maintain knowledge EDI Industry standards, concepts, practices, and proceduresMaintain strong understanding and alignment with assigned Business Area Strong understanding all technology in use by the Business AreaGeneral understanding of other technologies in use at NeighborhoodUnderstanding of operational processes within the Business AreaActively provide IS input to the operations and planning of the Business AreaIdentifies and advocates for opportunities to bring additional IT value to the Business AreaAssist the EDI Team Lead in the development of business cases and/or business plansDocuments key work flows within the assigned Business DepartmentCreates enduser documentation on Neighborhood technology where necessaryCollaborates with the PMO on development of business cases and on project deliveryProvides departmentfacing business consulting support relative to Neighborhoods healthcare payer system and other software applications.Act as a liaison between department and technical groups, using his / her expertise in Neighborhoods healthcare payer system and other software application expertise and superior communication skills to elicit, document, analyze and validate requirementsApply industryspecific expertise to recommend and coordinate the development, enhancement, and maintenance of a department's business systems, processes, and products.Combine industry expertise with a thorough understanding of information technology to develop innovative business solutions. Influence the strategic direction of the supported department(s).Participate in analysis of large projects.Participate in requirements management and change management processes.Leverage industry knowledge and client relationships to assess the business implications of the application of technology to the current and future business environment and to identify new business opportunities.Promote and direct process improvement activities and training of peers and department membersProvide time / resource estimates for assigned projectsExpected to develop innovative solutions to complex business and technology problems.Other duties as assigned.Corporate Compliance Responsibility As an essential function, responsible for complying with Neighborhoods Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies, and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect, and report unlawful and/or unethical conduct by fellow coworkers, professional affiliates and/or agents.