*KINDLY REFER IF YOU HAVE ANY FRIENDS INTERESTED FOR ANY OF THE BELOW
OPENINGS*

*Requirement Details:*



*Job title: **Healthcare EDI Eligibility Analyst*

*Location: **Baltimore, MD*

*Duration: 12+ months*

*Job Description*:

*Primary job responsibility is to assume responsibility for the
development, internal production and support process related and ensuring
the timely and accurate processing of 834 X12 Eligibility files for
Eligibility submitted by Plans maintained in the healthcare Membership
system and other EDI related files. *



*Major Duties and Responsibilities:*

Primary analytical role related to the claims adjudication system and
internal processes.

Responsible for importing, validating and reporting data into database or
exporting data from the database into appropriate EDI formats to support
business processes.

Responsible for developing and testing *HIPAA EDI 5010 X12* mapping formats
(*834, 999*) as well as industry standard and custom formats using ETL
tools.

Manage day-to-day production file monitoring for complex 834 Eligibility
file processing including troubleshooting and error investigation.

Coordinate with external clients and internal operations depts. to ensure
effectual setup and design of data formatting and flow for new client
implementations.

Monitor routine reporting between Clearinghouses, Health Plans and / or
Provider networks to maintain regulatory compliance with EDI transmission
reconciliation

Provides ad-hoc data/reports to clients or internal departments per request.

Produce comprehensive documentation of all developed software &
repositories.


-- 
*Thanks & Regards,*
Sam Thomas

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