EDI Business Analyst

Job Description:

EDI Business Analyst Summary:

Signature Consultants is seeking an EDI Business Analyst for an opportunity in Miami, FL. The EDI Business Analyst is responsible for designing and managing various electronic data flow processes along with receiving support calls to troubleshoot any EDI customer service issues. This BA will act as the IT support point of contact for electronic communication via EDI between outside vendors and clearinghouses. The qualified candidate will participate in system design and quality assurance activities. This position requires a mix of technical knowledge, analytical ability, clear written and verbal communication skills, and an understanding of system processes and production workflows. A deep understanding of HIPAA requirements and X12N EDI Professional and Institutional (not limited to 837, 835, and 834) is required. General system troubleshooting processes from problem notification through resolution is required. The EDI Business Analyst handles communications with trading partners for EDI transaction set-up and ongoing maintenance; coordinates between trading partners and networks to ensure mapping compliance; develops guidelines, checklists, procedures, and training documentation as required; and actively communicates with team members, management, end users, and external partners to promote sound EDI integrations and related system improvements. The EDI Business Analyst is able to perform all aspects of the position with additional responsibilities including but not limited to those outlined below.

Primary Responsibilities:

• Able to analyze current business processes and create an equivalent electronic process that can help improve business speed and internal costs.
• Conducts statistical analysis to determine data reliability.
• Performs daily EDI-related tasks such as daily claims reports, total count by vendors, and any report discrepancies.
• Acts as a Subject Matter Expert and escalation specialist in regard to problems or situations within the EDI team.
• Performs troubleshooting with new and existing trading partners to resolve technical mapping variations or gaps and first-level troubleshooting issues in the production environment.
• Establishes and maintains clearinghouse relationships.
• Works with project managers in relation to new product launch plans.
• Works well under pressure and multitasks in an interrupt-driven environment.
• Participates in special projects and performs additional duties as required.
• Assists other team members as necessary.
• Develops and implements systems procedures and forms to improve data collection and management.
• Responsible for acting in accordance with and complying with all departmental and company policies in relation to:
  • Compliance Program
  • Risk Management Program
  • Medicare Program
  • Medicaid Program
  • And others
• Ensures data and referential integrity by applying established standards.
• Generally work is self-directed and not prescribed.
• Works with less structured, more complex issues.

Requirements:

• Bachelor's degree or HS diploma/GED with 3+ years HIPAA EDI-related business experience
• 2+ years EDI experience including x12.5010; Professional and Institutional
• 2+ years of Intermediate hands on experience with SQL Server and Process Automation.
• Experience with clearinghouses such as Emdeon, Zirmed, and Availity.

Preferred Qualifications:

• Experience with HL7 & DICOM Transactions.
• REGTAP, Amazon Web Servers, Edge Server.
• Bilingual (English and Spanish) preferred.

About Signature Consultants, LLC

Headquartered in Fort Lauderdale, Florida, Signature Consultants was established in 1997 with a singular focus: to provide clients and consultants with superior staffing solutions. For the eighth consecutive year, Signature was voted as one of the “Best Staffing Firms to Work For” and is now the 14th largest IT staffing firm in the United States (source: Staffing Industry Analysts). With 26 locations throughout North America, Signature annually deploys thousands of consultants to support, run, and manage their clients’ technology needs. Signature offers IT staffing, consulting, managed solutions, and direct placement services. For more information on the company, please visit www.sigconsult.com.