EDI Analyst (Must reside in CA)

Description

Under general supervision of the Director of Business Informatics, this individual plays a role reporting and automating in support of various performance improvement efforts. The focus of this position is identification of clinical, operational, and business improvement opportunities through functioning as an analyst, as required within our clinical and operations performance improvement initiatives. This individual will also provide related educational services to DOHC staff and leadership, as necessary, to ensure meaningful action on data presented.

Professional Duties

• Implement and maintain automation for claims inbound and outbound processes for AZPC and DOHC
• Responsible for the daily loading and reconciling of electronic healthcare claims into the claims processing system for AZPC and DOHC.
• Ensure that trading partners have the data they need in order to send timely and clean claims data to AZPC and DOHC and alerting trading partner of any issues and working towards resolution of those issues
• Responsible for the preparation and distribution of encounter data for all health plans for AZPC and DOHC
• Responsible for EZ-CAP and EZ-Net user maintenance for AZPC and DOHC
• Will be primary support for EZ-CAP and EZ-Net users for AZPC and DOHC
• Maintaining and reviewing inbound and outbound maps to ensure Claims errors are minimized due to data integrity issues for AZPC and DOHC
• Effectively Uses Technology
• Perform other duties, as assigned.

Qualifications

• High School diploma or equivalent required; Bachelor Degree preferred.
• Healthcare experience preferred.
• Knowledge of SQL, preferred
• Basic understanding and working knowledge of EDI formats and Internet functions.
• Must be self-directed and able to work with minimal supervision
• Maintain effective, positive working relationships with team members and all departments.
• Excellent communication skills, detail oriented, critical thinking and problem solving skills.
• At the discretion of DOHC/FHC management, this position has the potential to be a full or hybrid telecommuting position.

Physical Demands

Type Description

Sitting Approximately 70% of day.

Standing Approximately > 15% of day.

Walking Approximately > 15% of day.

Lifting 0 - 20 lbs. (equipment, supplies) approximately >10% of day.

Bending Approximately >10% of day. Kneeling <20%.

Hearing/Visual Acuity Adequate for use with computers, telephone and/or Blackberry. Approximately 50% of day.

Computer Highly technical work environment. Must be able to work minimum of 6 hours a day using keyboard, mouse and monitor.

Reaching Above head 75 degrees approximately 25% of day.

Hand grip dexterity Approximately 40% of day.