EDI Analyst
Position Overview
With Zelis, an EDI Analyst collects and stores data related to healthcare claim reimbursements, market research, logistics, linguistics, or other behaviors.
They bring technical expertise to ensure the quality and accuracy of that data, then process, design and present it in ways to help people, businesses, and organizations make better decisions.
Key Responsibilities
Evaluate design and technical layouts for purposes of data mapping, integration analysis, scripting, testing and software conversion
Focus on new and supplemental implementations and change requests
Conduct full lifecycle analysis to include requirements, activities and design
In collaboration with the rest of the development team, ensure that the proposed solution addresses all of the client’s business requirements
Perform quality review checks on project deliverables
Import or Export, research and interpret ANSI X12 files coming from various sources. Formats include : 837I, 837P, 835, 834, 278 and 999
Communicate with payers to get clarification on requirements
Support application testing, implementation, and training activities
Qualifications
3+ years of experience working with EDI transactions in a high- volume data processing environment
Knowledge of ANSI specifications (ANSI 834, 835, 837, 820, 277) and the ability to determine ANSI related problems / errors
Basic understanding of NACHA rules, policies, and operations that impact 835
Ability to learn other transaction types as defined by business needs
Ability to recognize issues, provide solutions, and drive positive change
Ability to work with stakeholders to assess potential risks
Ability to analyze existing tools and databases and provide software solution recommendations
Ability to translate business requirements into non-technical terms
Experience in methodologies and processes for managing large scale databases and relational databases
Understanding of metadata standards
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