Electronic Data Interchange Analyst
Company: Physicians of Southwest Washington (PSW)
Location: Olympia
Posted on: February 18, 2021
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Job Description:
Summary / Objective: The Electronic Data Interchange (EDI)
Analyst will design, implement and maintain data interchange
systems betweenPSW and external partners/clearinghouses as well as
facilitate the automated transfer of data between departments. In
this role, the EDI analyst will be meeting with stakeholders to
understand their data interchange needs, designing appropriate EDI
systems, and training the involved parties on the use of the
system. The EDI analyst will be responsible for validation and
documentation of the current state of data exchanges within the
enterprise. The EDI analyst will work with key IT stakeholders to
establish and improve automation and validation of data exchanges
within the enterprise. They will serve as the primary link between
the business and any data-trading entities.Essential Functions: ---
Analyze and document business needs related to electronic data
interchange.--- Develop, configure, test, maintain, and enhance
healthcare EDI transactions to and from our trading partners and
clearinghouses.--- Support day-to-day operations of EDI, including
identifying any technical problems with sending/receiving
transactions such as claims, encounters, enrollment, provider data,
authorization data, and clinical data.--- Coordinate with health
plans, providers, vendors, clearinghouses, and internal departments
to address implementation, technical, and support issues related to
EDI.--- Review electronic data received from providers/vendors to
ensure file completeness and accuracy of data elements.--- Analyzes
file and data element level information to troubleshoot and perform
root cause analysis for data, transmission, and mapping errors.---
Implement new and update existing Companion Guides and Trading
Partner Agreements--- Coordinate response to ad-hoc data requests
from the trading partners in conjunction with the Business
Intelligence team.--- Organize transaction flows between internal
and external systems.--- Document transaction maps and flows---
Maintain and update related documentation of policies and
procedures for EDI.--- Design and create reports to monitor data
accuracy and statistics.--- Ensure compliance with PSW policies and
procedures with special emphasis on HIPAA requirements.--- Provides
advice and education to stakeholders concerning EDI guidelines and
capabilities.--- Designs, tests, and implements file automation and
validation systems where it will strategically benefit the
organization.--- Collaborates with programmers and internal staff
to develop and test new or modified systems for file validation
and/or transport.--- Develops and maintains communication links
with trading partners and oversees integration of information.---
Periodically reviews system to ensure stakeholder needs are met;
identifies possible modifications as required.--- Remains current
regarding EDI and internet field technological developments.---
Performs other related duties as
assigned.Knowledge/Skills/Abilities: --- Basic understanding and
working knowledge of EDI formats and configurations--- Experience
with HIPAA transactions and code set standards.--- Basic
proficiency with SQL.--- Proficient in Microsoft Office Suite or
related software.--- Organizational skills and strong attention to
detail.--- Strong analytical and communication skills.--- Creative
problem-solving required to design systems that meet stakeholder
individual needs.--- Ability to work independently and as part of a
team.Supervisory Responsibility: --- This position has no direct
reports and supervisory responsibilities are limited to
self-management.Required Education and/or Work Experience: ---
Bachelor's degree in computer science, information management, or
five or more years of IT business analysis related on-the-job
experience.--- Experience with FTP/FTPS/SFTP protocols--- High
degree of technical expertise regarding data mapping.--- Strong
knowledge of standard EDI transactions--- Strong analytical skills
with the ability to collect, organize, analyze and disseminate
significant amounts of information with attention to detail and
accuracy.--- Adept at queries, documentation, and
self-management--- Experience and working knowledge of Microsoft
productsPreferred Education and/or Work Experience:--- Experience
in the use of secure file and data transfer technology toolsets
(e.g. Globalscape) or ability to grow into a tool and help lead the
implementation of it.--- Experience with ANSI X12 and HL7/FIHR file
standards--- Experience in testing methodologies, test plan design,
and execution--- At least three (3) years' experience in the
healthcare field.--- Advanced understanding of the Medicare
Advantage or CMMI Innovation programs
Keywords: Physicians of Southwest Washington (PSW), Olympia , Electronic Data Interchange Analyst, Professions , Olympia, Washington
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