EDI Senior Analyst - Remote (Potential Sign On Bonus for Qualified Full Time Hires) - 2205030100
Description :
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
JOB SUMMARY:
The EDI Senior Analyst performs operational oversight, as it pertains to receipt, tracking, importing/exporting, and balancing of Electronic Data Interchange (EDI) files sent to and received from its designated business associates. The EDI Senior Analyst must possess strong technical abilities as well as a thorough understanding of his/her designated processing platforms, with familiarity of a variety of the field’s concepts, practices, and procedures. Responsibilities also include performing processing analysis to report departmental statistics to the EDI Team Leader, as well as possess competency to research and perform analysis to ensure completion of process and assist in completion when process is delayed.
DEGREE OF SUPERVISION:
This position reports to the EDI Manager and requires minimal degree of supervision to ensure tasks are appropriately prioritized.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Operates multiple data entry platforms to process/load data files in an electronic format and create output that is used in various forms
Leads training sessions on assigned EDI platforms for new company employees as well as provide extensive training to new EDI staff on specified projects performed by EDI team if the EDI Manager or EDI Team Leader are unavailable
Inventory individual electronic files, balance receipts to processed files, correct rejects and generate selected reports
Must be able to grasp and be trained in support of the HIPAA, Data Warehouse, and Crystal Enterprise servers
Coordinates the uploading and balancing of electronic claims with the appropriate platform (Production Engine, Macess Coordinator, etc), or other claims management personnel on a daily basis and reports all discrepancies immediately
Must be able to apply knowledge of business environment to assist in support of implementation and maintenance of software products utilized by the company
Display troubleshooting ability with designated software and application based issues
Coordinates, tracks, and monitors the progression of the Enhanced Data Analytics queue and review/approval process
Ensures integrity of the validation process on all data intake processes
Performs research and provide weekly past due reports to the EDI staff, as delegated by the EDI manager, and follow up with individual members to ensure that late tasks are completed as quickly, efficiently, and accurately as possibly
Adhoc reporting to support business initiatives
Supports interfaces to/from application environments
All other job related duties as they pertain to the job function or as delegated by the management team
Qualifications :
Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment activity. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Excellent problem solving and written and oral communication skills
Strong technical ability
Experience with data analysis and the ability to report writing in specific reporting applications (Crystal Reports or Microsoft Access).
Working knowledge of claims department operational functions and overall workflow
Ability to meet priorities and deadlines
Proficient in Microsoft Office suite programs (Word, Excel, Access, etc)
Additional knowlegde as required to support assigned applications/platforms
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience required to perform the job.
High school graduate or GED equivalent is required. Some college is preferred or 2 years related experience
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to work in a sitting position, use computer and answer telephone
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Office Work Environment
Job : Conifer Health Solutions
Primary Location : TX-Frisco
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Job Type: : Full-time
Shift Type: : Days
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Req ID: 2205030100
