EDI Analyst Job in Austin 78758, Texas Us
Responsibilities:
Essential Functions:
- Responsible for integrating the new Practice Management system into the existing/new EDI environment
- Work with Operations, EDI vendor and trading partners as required to increase the existing number/percentage of electronic claims and payments
- Work with Operations and Practice Management system vendor to implement a new electronic benefits verification system
- Coordinate with EDI vendor on all new enrollments and required information to support and maintain company's EDI relationships
- Coordinate with EDI vendor on the testing and implementation of EDI transactions with new and existing trading partners
- Work with trading partners as required to understand, document, and disseminate their EDI requirements.
- Develop production related EDI reporting requirements
- Interface with Operations and EDI vendor regarding EDI support-related issues
- Interface with senior/middle management and internal business units to ensure that the EDI program achieves the organization’s strategic goals and business needs
- Provide guidance to the department’s EDI personnel
- Define and implement new or improved work processes to increase quality and efficiency
- Provide timely reporting to management regarding production issues and trends
- Resolve non-standard issues that cannot be resolved by the EDI vendor
Additional Responsibilities:
- Performs other duties or special projects as assigned
- Ability to complete multiple simultaneous projects in a timely manner
Qualifications:
Required Skills Abilities:
- 5+ years healthcare EDI (e.g. claims, payments, benefits) experience in a large healthcare production environment
- 2+ years experience developing Healthcare EDI translation maps
- Familiar with ICD-10 and HIPPA 5010 standards
- Demonstrated experience onboarding new payers for electronic claims electronic payment processing
- Demonstrated ability to independently research, analyze, and troubleshoot complex EDI-related issues
- Knowledge of federal and state DME regulations and familiarity with commercial payer rules and regulations
- Demonstrated experience leading several full life cycle implementations with an understanding of all aspects of an implementation project including, but not limited to, planning, analysis and design, configuration, development, conversions, system testing, cutover and production support
- Must organize/prioritize work, manage multiple tasks and projects and function effectively as a small-team member.
- Must be able to function independently, or as a team member, and have superiod communication and interpersonal skills.
Preferred Skills/Experience:
- Experience with NextGen PM/EHR
- Familiarity with ITIL is desired
- Healthcare systems (Revenue Cycle Management, Practice Management, Outcomes Assessment)
- Strong PC skills with a working knowledge Microsoft Office suite, with strong skills in Excel, Word, PowerPoint, Visio and Project
Required Credentials:
- B.S. or B.A. in business or information systems; professional certification in healthcare EDI preferred. Relevant experience with non-analytical degree or equivalent professional training may be substituted.
MRINetwork, one of the world's largest search and recruitment organizations, has approximately 850 offices in over 40 countries. Each office is a single point of contact that allows candidates to access high-quality positions virtually anywhere in the world.
MRINetwork recruiters are industry specialists who typically have real-world experience in the industries they serve.