POSITION SUMMARY
The EDI Analyst works with both internal and external partners to facilitate the exchange of data between different sources to meet required technical, operational, and business needs. Serves as a subject matter expert and provides analytical support to the EDI Team and all users of the data within the EDI interfaces.
ESSENTIAL FUNCTIONS
- Analyze and maintain benefit files, including ANSI X12 834 file specifications.
- Capture and document business and functional requirements, perform analysis, and testing.
- Ensure EDI offerings adhere to client needs and regulatory requirements.
- Collaborate with carriers and vendors to review requirements, coordinate testing, and ensure new files are production-ready.
- Track an active pipeline of assigned ongoing file integrations.
- Troubleshoot and support client and partner inquiries regarding existing EDI integrations.
- Utilize available configuration tools to build file process automations.
- Work with the internal team to build, manage and improve file automation and maintain SFTP exchanges.
- Participate in sustainment activities such as production monitoring, file maintenance, and tracking the EDI lifecycle.
- Resolve issues, answer customer questions, and identify patterns or trends to recommend solutions.
- Provide technical support to colleagues, offering recommendations for problem resolution.
- Develop new processes and procedural documentation.
- Collaborate with various business teams to enhance efficiency and speed of internal operations through process or system improvements.
- Responsible for ensuring successful transfer of inbound EDI enrollment data to include troubleshooting/reconciliation of data integrity issues.
- Responsible for managing EDI file activity for high-profile/complex EDI client business (BPO, non-standard, etc.).
- Communications between EDI vendors, clients, Account Management teams, Customer Experience teams, and project teams.
- Responsible for supporting project work within the business area (lead and/or participate in project meetings, business requirement documentation, etc.).
EDUCATION
- Bachelor’s degree or equivalent work experience required.
EXPERIENCE AND SKILLS
- Minimum 2 years of experience in EDI, Data Analysis and Testing required. Healthcare claims and managed care experience is highly preferred
- SQL Query experience required
- Experience data mapping and documenting business and technical requirements
- Experience working with X 12 formats preferred.
- Effective organizational and prioritization skills
- Experience communicating complex technical information to a non-technical audience
- Intermediate knowledge of Microsoft Word, Outlook, and PowerPoint
- Ability to learn new systems and continually update technical skills to adapt to changing technology
- Basic data-gathering skills including coding (SQL), testing, debugging, and documentation
- Knowledge of common database architectures and how to extract and transform complex datasets
POSITION COMPETENCIES
- Accountability
- Analytical Thinking
- Collaboration
- Communication
- Customer Focus
- Functional Expertise
- Initiative
PHYSICAL DEMANDS
- This is a standard desk role requiring extended sitting and computer work
WORK ENVIRONMENT
Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.
