EDI Analyst
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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The Enrollment Source Electronic Data Interchange Analyst will work with internal and external partners to increase electronic transactions and improve accuracy, leading to decreases costs and greater ease of working with Bright Health for our Members and Care Partners.
ROLE RESPONSIBILITIES
- 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
- reconciliation
- 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
PROFESSIONAL COMPETENCIES
- 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
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
Focusing on Consumers
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
Building on Alignment
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.