EDI Analyst at Bright Health
- The Enrollment Source EDI Analyst job description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Responsible for federal marketplace (FFM) enrollment source EDI processing and data
- Reviews and actions all enrollment source specific reports
- Performs EDI analysis, research, and documentation of transactional data set requests and issues from internal and external customers
- Documents and manages tickets associated with EDI problems
- Provides technical support during and after implementation for healthcare electronic data interchange applications
- Provides analysis, support and guidance on complex electronic data transfers covering enrollment, premium billing statements and payments
- Reviews existing EDI processes, procedures and systems to improve submission rate and improve the quality of each encounter with EDI
- Establishes EDI standards, policies and procedures and champions them throughout the organization
- Acts as a subject-matter resource to enrollment and premium billing team
- Other duties and responsibilities as assigned
- This position does not have supervisory responsibilities.
- The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- Bachelor’s Degree in Applied Computing or equivalent work experience preferred
- One (1) year experience with enrollment EDI operations and analysis in a healthcare industry required
- Strong experience with 834 enrollment processing required
- Experience handling EDI transactions coming from federal marketplace (FFM) required
- Superior analytical ability and aptitude to design and construct meaningful business reports, investigate problematic data to discover root cause, and ability to create remedial actions to accomplish desired business results
- Self-starter with the drive and motivation to identify and resolve enrollment issues with minimal direction
- Individual contributor but cross-functional team leadership skills are required