Position: EDI Analyst
Location: Glendale, CA
Duration: 3-6 months
Start: ASAP
DL: 55/hr
Important: medical / healthcare background
Position Summary:
The Information System (IS) EDI Analyst - EDI & Business Operations Analysis
is responsible for managing the technical resources involved in EDI &
Operations Analysis. The candidate must oversee the day-to-day processes
used to collect & process data received from and sent to various vendors and
health plans. In addition, the candidate is also responsible for the
definition and implementation of product enhancements, which include, but
are not limited to operational process change, quality measures, system
upgrades and strategic focus of Senior Management. The candidate will be
tasked to work and lead cross functional teams in a collaborative manner to
deliver structure design, projects on time, and communicate status to all
concerned parties.
.
Job Duties and Essential Functions:
1. Maintains and keeps in total confidence, all files, documents and
records that pertain to the operation of business of Company.
2. Utilizes and demonstrates a working and integrated knowledge of the
business relative to:
specific applications supported Internal and external departmental policies
and procedures, workflow, and business need.
3. Responsible for troubleshooting and problem solving of MS-SQL and
other applications.
4. Functions as a lead data expert working collaboratively with other
data analysts in support of company initiatives.
5. Develop strategies to improve HEDIS rates.
6. Analyzes HEDIS coding compliance.
7. Identifies issues related to source system data inputs and
integrity. Implements short and long-term approach to data and/or reporting
capability deficiencies. Validates and verifies accuracy of reports and
other outputs.
8. Responsible for implementing, supporting, and customizing
applications in support of business requirements and initiatives.
9. Must be able to apply knowledge of business environment to assist in
support of implementation and maintenance of software products utilized by
company
10. Supports interfaces to/from application environments
11. Will serve as back-up to EDI Technician functions.
12. Provides regular formal (documented) status reports as required by
supervisor/manager/department head
13. Maintains and keeps in total confidence, all files, documents and
records that pertain to the operation of business of Company.
14. All other job related duties as it relates to the job function or as
delegated by the management team
Educational Requirements:
Bachelors Degree in Computer Science/other related field preferred or
equivalent experience.
Some college with a minimum of 3 years technical training required.
Experience/Skills Requirements:
Must possess strong written and verbal; communication skills
Must possess strong organizational and interpersonal skills
Working knowledge of Microsoft Office products and MS Project
Specific knowledge or experience with one or more of the following
application/programming environments: Microsoft SQL-Server or similar
database, Visual Basic, C++
Strong understanding of HEDIS, NCQA, HIPAA, and other regulatory/industry
reporting standards and/or previous experience with reporting encounter
data.
Demonstrated experience in data analysis and report writing using technical
tools such as Crystal Reports, MS Access, etc.
Strong understanding of claims and coding.
Strong research, analytical, problem solving, time and project management
skills.
Experience in the healthcare field, specifically medical group management
preferred.
Programming in programs such as VB6/.net, Transact SQL is highly desired.
A strong background in statistics is highly desired.
Thanks,
Alexandra Castillo
Corona Technology Staffing, Inc.
(305) 433-8041
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