Medical EDI Operations Analyst

Responsible for daily management of error queues for EDI Medical State Reporting and Medical Data Call.

keywords: Operations Analyst, Junior Operations Analyst,Data Operations Analyst,Business Operations Analyst

Key Responsibilities – To simplify complexities for each customer :

Performs research and correction of errors of varied complexity using internal tools

Responsible for meeting weekly and monthly production requirements for timely and accurate error resolutions

Works with internal stakeholders to identify and resolve missing or incorrect data

Uses ticketing system to report and track issues which may require system improvements or IT intervention

Communicates effectively with Product Owner and Account Management teams

Additional tasks as assigned by manager

keywords: Operations Analyst, Junior Operations Analyst,Data Operations Analyst,Business Operations Analyst

Additional Responsibilities:

Strategic Initiatives: Actively engages in driving strategic initiatives, and the related goals, to ensure the most optimal outcome.
Communication: Effectively communicates using written, oral, non-verbal, and active listening skills. Has the ability to clearly present an idea or concept so others understand, lets others speak, and engages productively in difficult conversations while upholding our ethical values.

Position Qualifications :
keywords: Operations Analyst, Junior Operations Analyst,Data Operations Analyst,Business Operations Analyst

Qualifications/Education/Certifications:

An associate degree from an accredited college or university and 2 years’ industry experience in medical bill review, billing clearinghouse and/or workers’ compensation claims processing environment; or equivalent combination of education and experience.

Knowledge, Skills and Abilities:

Understanding of 837, 997, 999, 824 and Flat file formats
Possess a general knowledge of workers’ compensation data reporting rules and concepts
Effective verbal and written communication skills
Ability to shift priorities quickly and work on multiple tasks simultaneously
Must be able to understand and adhere to written policies and procedures
Knowledge of execution of basic SQL queries highly preferred
Working knowledge of MS Office

Job Competencies:

Action Orientation
Customer Engagement
Flexibility
Interpersonal Effectiveness
Character
Results Focus
Collaboration

Physical Demands/Working Conditions:

Duties are performed primarily in an office setting. Operates computer and standard office equipment, such as telephone and copier/printer.

*** Job descriptions will be reviewed and are subject to changes of business necessity. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.