Demo

Lead EDI Data Analyst (HIPAA X12 EDI Transactions )

Corelleaf Design Studio
Mason, OH Full Time
POSTED ON 3/27/2025
AVAILABLE BEFORE 5/26/2025

Description:

The Medicaid EDI Manager will play a critical role within the Business Data Solutions team to maintain and implement Medicaid encounter feeds. The Medicaid Manager will be the primary resource implementing new client and/or state outbound transactions. The Manager will develop requirements based on stakeholder meetings and interpretation of Companion Guides. The Manager will identify, recommend and implement process improvements in support of the EDI system based on observation, monitoring and external inquiries regarding EDI issues.

Secondary responsibilities include researching and analyzing encounter edits or rejections for Medicaid clients and work with internal/external teams to resolve. The Manager will work to improve overall encounter, member and provider data quality. As well they will track encounter submission quality and timeliness.

Specific Skills Needed:
Top 3-5 mandatory and/or minimum requirements:
Ability to analyze claims data Develop standard and custom testing plans to ensure compliance with requirements
Maintain detailed documentation and process flow of all EDI processes

Top 3-5 desirable attributes/qualifications:
HIPAA X12 EDI Transactions experience
Experience with EDI mapping for 837, 999, 277CA, 835
Experience with Medicaid Claims processing

Notes:
8:*00am to 5:*00pm
Hybrid: 3x a week

Job Type: Contract

Pay: $60.00 - $61.50 per hour

Expected hours: 40 per week

Schedule:

  • 8 hour shift

Ability to Commute:

  • Mason, OH 45040 (Preferred)

Ability to Relocate:

  • Mason, OH 45040: Relocate before starting work (Preferred)

Willingness to travel:

  • 25% (Preferred)

Work Location: In person

Salary : $60 - $62

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