EDI Business Analyst

Description

Summary

Apex Health Solutions is leading a healthcare transformation through our partnerships with physicians and healthcare insurers. Through our unique models, Apex empowers physicians to truly manage a patient's health, delivering high quality, affordable care in a modern, patient focused approach.

The EDI Business Analyst is responsible for ensuring EDI transmissions meet platform specifications in terms of business requirements, application design and infrastructure requirements. Collaborate with project managers and business analysts to define product development tasks and estimates. Develop, implement and/or modify business processes to support automation with new or existing trading partners and/or customers. Work closely with EDI development staff to provide break fix analysis on existing processes. Troubleshoot all reported errors and provide proper documentation and feedback. Resolve auditing errors and determine if customer audit procedure changes are needed. Communicate with management and/or plan operations to understand any changes or concerns in auditing procedures. Provide management with insight into any customer specific issues or trends that adversely affect the auditing process. Proactively work to assist others in achieving the organization's objectives.

Essential Functions

Design, develop and implement X12 EDI solutions for healthcare transactions such as claims, eligibility, and remittance advice (834, 835, & 837).
Conduct thorough testing of EDI transactions to identify and resolve any issues, ensuring data integrity and compliance with standards.
Use a combination of analysis and experience to define, validate, and combine data across multiple sources.
Create and maintain documentation for EDI processes, mappings, and configuration, facilitating knowledge transfer and ensuring system understanding.
Ensures that project requests are clear, concise, measurable, and marketable with well-defined acceptance criteria.
Drives resolution of issues related to production issues, escalating when appropriate.
Utilize EDI mapping tools to transform data between different formats, ensuring accurate and secure exchange of healthcare information.
Provide mapping information and processing input to SQL developers to enable the appropriate database design best suited to the data.
Work with developers to present data in a meaningful and appealing manner that provides the most decision support value to the users.
Participates with technical and data analysis teams to troubleshoot defects (technical and functional) during post-release support.
Monitor the production environment and proactively prioritize, communicate, and help to resolve any operational EDI process or system issues.
Proven SQL query skills and knowledge of SQL database concepts such as tables, data types, keys, joins, indexes, transactions.

Education

Bachelor's Degree in Computer Science or equivalent experience.

Experience

Minimum 3+ years of experience working as an EDI Business Analyst in a technical environment with responsibilities in developing business requirements, data analysis, developing solutions, supporting both business and technical teams.
Axiom TransSend experience a plus.
Agile Methodologies domain experience a plus.

#J-18808-Ljbffr