Electronic Data Interchange Analyst

Company: Physicians of Southwest Washington (PSW)
Location: Olympia
Posted on: February 19, 2021

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 products
Preferred 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