SKYGEN · 1 month ago
EDI Analyst III
United States
Full-time
Remote
Mid, Senior Level
$90K/yr - $136K/yr
5+ years expSKYGEN is a company that specializes in healthcare solutions, and they are seeking an EDI Analyst III to act as a main point of contact and subject matter expert for EDI file exchanges. The role involves processing, troubleshooting, and delivering EDI files while collaborating with clients and internal teams to ensure efficient operations.
Health CareInsurance
Responsibilities
Process, troubleshoot, and deliver daily EDI files and reports to clients within required timeframes
Process inbound and outbound client files including analyzing data for accuracy and preparing a summary of data for clients
Work collaboratively with external vendors to gather necessary information for new set up
Set up new EDI processes on behalf of new vendors by assessing current system capabilities, providing proper solutions, testing outcomes, and providing general communication and support as needed
Work collaboratively with complex and/or larger clients throughout implementations by gathering requirements, validating files, inputting edits, testing files, and ensure compliance and accuracy
Track inbound and outbound file stats and provide an accounting of data received/sent
Troubleshoot escalated file processing errors
Act as primary resource for department projects
Participate in client and state audits
Regularly attend and participate in client and internal meetings as a representative of the EDI Department
Deliver ad hoc data to internal and external customers as appropriate surrounding problems affecting client eligibility and claim processing
Work collaboratively with internal departments to secure and maintain effective relationships
Act as a subject matter expert for high priority items sent to the EDI team; answering questions to internal and external contacts and resolving matters that may fall outside of the established workflows
Respond timely and accurately to client inquiries regarding reported data, incoming client eligibility and outgoing client claims, encounter, provider and other information
Prepare ad hoc data extracts, reports, and analysis
Perform routine and ad hoc data maintenance
Properly communicate technical information to internal and external clients to ensure shared understanding
Provide training to new and current department staff to ensure understanding
Work collaboratively with internal teams to keep them informed of potential issues and/or concerns
Qualification
Required
Bachelor's degree in Information Technology, Computer Science, or related field or equivalent years of internal experience
Minimum of 5 years of related experience or equivalent advanced education
Experience in demonstrating informal leadership skills
Strong knowledge of database application and data query protocol (MS SQL Server, Transact-SQL)
Strong problem diagnosis and resolution skills
Strong verbal and written communication skills
Ability to resolve complex problems
Ability to work autonomously
Good problem solving and decision making abilities
Conflict management skills
Ability to successfully have conversations with others regarding challenging/sensitive topics
Ability to adapt to changing priorities quickly
Ability to demonstrate professional behavior
Ability to work overtime as needed
Preferred
Master's degree in Information Technology or equivalent field of study
Previous EDI experience
Knowledge of HIPAA requirements
Company
SKYGEN
SKYGEN transforms dental and vision benefits management and administration with flexible technology and services that connect and change lives for the better.
501-1000 employees
H1B Sponsorship
SKYGEN has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (13)
2024 (12)
2023 (10)
2022 (14)
2021 (7)
2020 (6)
Funding
Current Stage
Late StageLeadership Team
Craig Kasten
CEO and Managing Partner
Steven J. Berryman
Chief Executive Officer
Recent News
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