Jobs via Dice · 13 hours ago
Sr. Systems Analyst
Baltimore, MD
Full-time
Onsite
Mid, Senior Level
4+ years exp4A Consulting is a women-owned, boutique consulting firm specializing in delivering innovative, data-driven solutions to both the Federal Government and Fortune 500 clients. The Analyst, Systems (Senior) will provide data analysis, transactional support, error detection, resolution, and all related services for successful Electronic Data Interchange (EDI) Operations of the Exchange.
Computer Software
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
Analyze 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 analyze, fix, test, and transmit EDI files daily and as required
Analyze 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 analyze 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
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 analyzing, 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 enrollment transactions, including Adds, Changes, Terminations, Cancellations, and error processing
Benefits
Access career development programs, mentorship, and learning opportunities.
Enjoy a comprehensive benefits package, flexible work options, and a focus on work-life balance.
Company
Jobs via Dice
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0-1 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase