Sr. EDI Data Analyst
Work From Home - AZ
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Join us for an exciting career with the leading provider of supplemental benefits!
Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
Core Competencies:
- Collegiality: Building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth.
- Initiative: Readiness to lead or take action to achieve goals.
- Communicative: Ability to relay issues, concepts, and ideas to others easily orally and in writing.
- Member-focused: Going above and beyond to make our members feel seen, valued and appreciated.
- Detail oriented and thorough: Managing and completing details of assignments without too much oversight.
- Flexible and responsive: Managing new demands, changes, and situations.
- Critical Thinking: Effectively troubleshoot complex issues, problem solve and multi-task.
- Integrity & responsibility: Acting with a clear sense of ownership for actions, decisions and to keep information confidential when required.
- Collaborative: Ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.
Essential Functions:
- Engage actively with the Encounter and Implementation teams to understand the steps of the encounter/rejection process for states/clients.
- Participate in State/Client Encounter discussions, acting as a subject matter expert and providing input on suggested process improvements.
- Accurately interpret and understand State Encounter/Rejection requirements for multiple markets.
- Develop and maintain controls over the Encounter processed data and systems.
- Oversee the auditing process and monitor exposure and potential penalty risk. Improve process as business dictates.
- Resolve escalated issues on behalf of EDI staff; work with internal staff as needed to ensure the resolution of escalated issues related to Encounters/Rejections.
- Analyze exception data and correct code errors/issues. Submit accurate and timely Encounter Acceptance Rate Reports.
- Identify trends and inefficiencies in procedures, reports, and workflow to support continuous improvement.
- Provide feedback to the manager on recommendations for additional training or coaching to foster continued staff development.
- Partner with the management team to resolve potential issues and concerns.
Minimum Qualifications:
- Associate degree in Business Administration/or Healthcare related field or 5-7 years of related work experience.
- 3-5 years of prior job-related experience demonstrating …
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Benefits/Perks Tasks- Improve processes
- Resolve escalated issues
Ada Auditing Collaboration Communication CPT Critical thinking Excel HCPCS Leadership Development Microsoft Excel Microsoft Outlook Microsoft Word MS SQL Server Recruiting SQL Training
Experience3 - 5 years
Education
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