Job Description

Business Analyst (EDI, Jr-Mid Level)

Elite Technical is seeking a Jr-to-Mid-Level Healthcare Business Analyst to support our client with day to day EDI claim file loading and error review. We are seeking a passionate, results-oriented Business Analyst in the healthcare payer domain with specific knowledge around Medicare eligibility, EDI, 834, 835 and 837 (dental).

Responsibilities:
-Support daily claims files that will be uploaded into QNXT. Review claims rejections, 834 eligibility files for errors, outbound extracts for vendor eligibility, reconciliation of files for Medicare eligibility etc-
- Serves as a liaison between the business programs community and IT organization to create business requirements and assist with technical solutions to meet project needs.
- Analyze and document business requirements and processes; use and promote industry standard analysis techniques, such as data flow modeling, use-case analysis, workflow analysis, business process mapping.
- Break down high level information gathered into details including sources of data, data types, users, user types, interface components, interface navigation needs, reporting needs, and administrative system needs.
- Produces business design document based on product and solution requirements.
with teams to ensure timely resolution and delivery of high-quality products and solutions.
- Partner with stakeholders on requirements prioritization, solution approach and alternatives, and manage requirements changes to ensure developed solution conforms to business needs.

This position is a fulltime/direct FTE opportunity with our Healthcare client who is offering a generous salary and benefit package. For the first 4-6 months during training, this position will be onsite 5x per week in Elkridge MD. Once training is completed, this position can move into a hybrid telework opportunity.

Required Skills

- Degree is preferred, not required.
- 2+ years as a Business Analyst within a Healthcare Payor Environment.
- Familiar with claims administration systems and terminology - working knowledge of Eligibility and Enrollments, Administration of Plans, Benefits, Claims, Accumulators, and Provider Payments
- Experience with SFTP, EDI X12 transactions 834, 835, 837 is required
- Must be able to communicate effectively with internal and external stakeholders
- Ability to create complex SQL queries that includes but not limited to extract data, update and insert functions
- Proficient in Microsoft Office including Outlook, Excel, Visio, PowerPoint and Word.
-Big Plus: QNXT and Medicare

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Job Tags

Full time, Work at office, Remote work,

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