CCS Global Tech · 5 hours ago
Senior System Analyst
Baltimore, MD
Contract
Hybrid
Mid, Senior Level
4+ years expCCS Global Tech is seeking a Senior Systems Analyst to support their Electronic Data Interchange (EDI) Operations. The role involves data analysis, error detection, and resolution related to Medicaid transaction files, as well as coordinating with various teams to ensure successful EDI operations.
Information TechnologyMobile AppsSoftware
Hiring Manager
Arnab Kumar Kar
Responsibilities
Provide data analysis, transactional support, error detection, resolution, and all related services for the successful Electronic Data Interchange (EDI) Operations of the Exchange
Perform 8001 Medicaid transaction file analysis and validations
Review and resolve all data issues, including but not limited to Master Data Management (MDM), Master Person Identifier (MPI), and other data issues
Perform HBX System Error analysis
Validate 1095-A and 1095-B files and reconcile 8001 transactions
Analyse EDI files sent to and received from Carriers, Managed Care Organizations (MCO), and other entities, and identify errors and root causes for EDI file rejections
Coordinate with the development team, business team, and testing team to analyse, fix, test, and transmit EDI files daily and as required
Analyse the EDI 999 files from the Carriers and MCOs and perform root cause analysis for exceptions and assist with resolving any data issues
Perform data changes to fix consumer or system-reported errors, coordinate with technical and business teams to analyse error reports, access the HBX databases and applications to perform root cause analysis for transaction rejections, and provide data fixes and technical solutions
Communicate with the IT team, business team, vendor teams, and other stakeholders to translate business needs into EDI data fixes and solutions
Note: The candidate must have the flexibility to work overtime, as needed, including weekends, holidays, and off-hours
Qualification
Required
A minimum of four (4) years of experience with the Health Exchange marketplace EDI solutions
A minimum of four (4) years of experience creating EDI X12 files for transaction sets such as 834, 999, and TA1
A minimum of four (4) years of experience in reviewing and understanding technical documents such as companion and implementation guides for Healthcare EDI formats 834 and 999
A minimum of four (4) years of experience in analysing, testing, and providing data solutions for healthcare marketplaces
A minimum of two (2) years of experience working with SQL databases/queries
Strong analytical and problem-solving skills
Excellent communication skills, including the ability to understand and communicate technical information to business users and gather business requirements that can be translated into technical requirements
Ability to manage multiple critical priorities and tight deadlines
Preferred
A minimum of six (6) years of experience with EDI validation tools such as Edifecs, WTX, EDI X12 files, or equivalent
A minimum of six (6) years of experience with EDI transaction sets such as 834, 820, 999, and TA1, SOA, EDI, or EAI applications
A minimum of two (2) years of hands-on experience writing complex SQL scripts
Knowledge of the Affordable Care Act (ACA) eligibility rules for Medicaid and Qualified Health Plans
Experience with or knowledge of Medicaid 8001 file processing or any other inter-agency transactional file processing
In-depth understanding of EDI 834 enrolment transactions, including Adds, Changes, Terminations, Cancellations, and error processing
Company
CCS Global Tech
CCS Global Tech is an IT company that provides application development services.
501-1000 employees
H1B Sponsorship
CCS Global Tech 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 (70)
2024 (73)
2023 (58)
2022 (121)
2021 (82)
2020 (214)
Funding
Current Stage
Late StageLeadership Team
Mark Hunsicker
Sr. VP Account and Partner Management
Arti Pathak
AVP, Strategic Partnership
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