EDI Analyst

About the role

Job Summary: We are looking for an EDI Technical Support Specialist to provide helpdesk support. EDI experience is required. Provide ongoing frontline help desk telephone support to the EDI batch/real-time trading partner and secure web portal user community by investigating user needs and problems, discovering source of issues, and assuring optimal solutions are achieved. Educate and answer helpdesk telephone inquiries on relevant procedures and protocols related to electronic claim, eligibility, claim status, authorization and remittance batch and real-time processes. Serve as the first level of resolution to document/track stakeholder electronic transaction and connectivity issues, research complex application failures using diverse resources, determine severity and escalation levels, establish mitigation risk and report findings to management and business needs to Information Technology. Train Blue e users on web portal functionality and administrators on access security protocols. Provide input and assist with revisions to provider materials. Ensure the inquiry tracking database has up-to-date and complete documentation of service requests, statuses, and resolutions. Proactively monitor multiple EDI Production systems using available reports and dashboards to review compliance, error rates and maintain claim balancing. Ensure compliance with state, federal, HIPAA and BCBSA regulations governing stakeholders and suggest implementation of process modifications when necessary. Location: Telecommute. Job type: Contract.

Responsibilities

• Provide ongoing frontline help desk telephone support to the EDI batch/real-time trading partner and secure web portal user community by investigating user needs and problems, discovering source of issues, and assuring optimal solutions are achieved.
• Educate and answer helpdesk telephone inquiries on relevant procedures and protocols related to electronic claim, eligibility, claim status, authorization and remittance batch and real-time processes.
• Serve as the first level of resolution to document/track stakeholder electronic transaction and connectivity issues, research complex application failures using diverse resources, determine severity and escalation levels, establish mitigation risk and report findings to management and business needs to Information Technology.
• Train Blue e users on web portal functionality and administrators on access security protocols.
• Provide input and assist with revisions to provider materials.
• Ensure the inquiry tracking database has up-to-date and complete documentation of service requests, statuses, and resolutions.
• Proactively monitor multiple EDI Production systems using available reports and dashboards to review compliance, error rates and maintain claim balancing.
• Ensure compliance with state, federal, HIPAA and BCBSA regulations governing stakeholders and suggest implementation of process modifications when necessary.

Requirements

• Bachelor's degree or advanced degree (where required)
• 3+ years of experience in related field
• In lieu of degree, 5+ years of experience in related field

Qualifications

Must have 3 years of experience with EDI Helpdesk Support experience.

Skills

• database
• Information Technology
• secure web
• web portal
• Proactively
• business needs
• dashboards
• HIPAA regulations
• help desk
• helpdesk
• remittance
• Production systems
• Ensure compliance
• investigating
• risk

Benefits

• medical
• prescription
• dental
• vision
• AD&D
• life insurance
• short-term disability
• 401K plan

Pay

Salary: $35 - 38 per hour.

Schedule

Work hours: 9am to 5pm.