EDI Analyst V

The Electronic Data Interchange Analyst V provides system process support, problem resolution, project management, analytical, research, and statistical support to the billing process. Defines needs and system enhancement with participating departments. Researches and gathers data from applicable sources, such as interviews, phone surveys, and written documentation. Designs model, utilizing operational experience, knowledge and research. Provides support to senior management by analyzing, interpreting, and supplying information. Represents Patient Accounts in meetings with other divisions and departments as it relates to analyzing and interpreting data, data flows and operational processes. Monitors and maintains awareness of data processing demands in terms of government regulations, reimbursement issues and other matters having potential financial impact on the organization–Experience within a healthcare facility preferred

–System project management experience and problem resolution skills

–Experience working with complex data formats

–Experience accurately maintaining and updating data tables, extracting data and creating ad hoc reports from database platforms; specifically, Access, DB2 and MICROSOFT SQL Server

–Knowledge of 837, 835, 276, 277 ‘ X12 file formats

–Ability to analyze complicated systems and developed detailed specifications for modifications and enhancements

–Familiarity with external sources of demographic, financial, payer/provider information and utilization data for hospitals

–Comprehensive knowledge of Medi-Cal, Medicare and other third-party payor program requirements, billing codes, diagnosis codes and medical terminology

–Knowledge of and demonstrated skill with various spreadsheet and software applications including, MICROSOFT, EXCEL, WORD and ACCESS, TSO, AD HOC, SAS, SMS SIGNATURE, Invision or similar patient accounting system

–Understanding of programming principles related to projects and ability to integrate these with personal computer applications. Ability to design programming specifications and implement them

–Ability to pull together technical detail and summarize in simple terminology to present to senior management for approval of project direction.

–Extremely detail-oriented