Healthcare EDI Claims Analyst

Position : Healthcare EDI Claims Analyst (Mid Level or Senior Level)

Location: Remote

Duration : Long Term

Mode of Interview : Telephonic/Video

Job Description:

Key Responsibilities:

• Claims & Encounters Analysis (Inbound/Outbound 837)
• EDI Transaction - 270/271 Eligibility Benefits Inquiry
• EDI Transaction - 276/277 Claims Status Inquiry and Response
• Paper Claim Processing (FIS Vendor)
• Member and Provider Matching Analysis/Enhancement
• Recon Report Analysis and Core System Upload Failures
• Ad-hoc Claims Reporting

Skills Required:

• Strong understanding of EDI transactions and claims processing
• Proficiency in SQL and data analysis
• Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica, and Apigee
• Familiarity with CBH systems, including Connects and Flexicare

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