Demo

Sr Systems Analyst - EDI - mPower Software Services

mPower Software Services
Baltimore, MD Full Time
POSTED ON 1/22/2025
AVAILABLE BEFORE 4/21/2025

Duties / Responsibilities

  • Provide data analysis, transactional support, error detection, resolution, and all related services for the successful Electronic Data Interchange (EDI) Operations of the Exchange.
  • Perform 8001 Medicaid transaction file analysis and validations.
  • Review and resolve all data issues, including but not limited to Master Data Management (MDM), Master Person Identifier (MPI), and other data issues.
  • Perform HBX System Error analysis.
  • Validate 1095-A and 1095-B files, and reconcile 8001 transactions.
  • Analyze EDI files sent to and received from Carriers, Managed Care Organizations (MCO), and other entities, and identify errors and root causes for EDI file rejections.
  • Coordinate with the development team, business team, and testing team to analyze, fix, test, and transmit EDI files daily and as required.
  • Analyze the EDI 999 files from the Carriers and MCOs and perform root cause analysis for exceptions, and assist with resolving any data issues.
  • Perform data changes to fix consumer or system-reported errors, coordinate with technical and business teams to analyze error reports, access the HBX databases and applications to perform root cause analysis for transaction rejections, and provide data fixes and technical solutions.
  • Communicate with the IT team, business team, vendor teams, and other stakeholders to translate business needs into EDI data fixes and solutions.

Note : The candidate must have the flexibility to work overtime, as needed, including weekends, holidays, and off-hours.

Minimum Qualifications

  • A minimum of four (4) years of experience with the Health Exchange marketplace EDI solutions.
  • A minimum of four (4) years of experience creating EDI X12 files for transaction sets such as 834, 999, and TA1.
  • A minimum of four (4) years of experience in reviewing and understanding technical documents such as companion and implementation guides for Healthcare EDI formats 834 and 999.
  • A minimum of four (4) years of experience in analyzing, testing, and providing data solutions for healthcare marketplaces.
  • A minimum of two (2) years of experience working with SQL databases / queries.
  • Strong analytical and problem-solving skills.
  • Excellent communication skills, including the ability to understand and communicate technical information to business users and gather business requirements that can be translated into technical requirements.
  • Ability to manage multiple critical priorities and tight deadlines.
  • Preferred Qualifications

  • A minimum of six (6) years of experience with EDI validation tools such as Edifecs, WTX, EDI X12 files, or equivalent.
  • A minimum of six (6) years of experience with EDI transaction sets such as 834, 820, 999, and TA1, SOA, EDI, or EAI applications.
  • A minimum of two (2) years of hands-on experience writing complex SQL scripts.
  • Knowledge of the Affordable Care Act (ACA) eligibility rules for Medicaid and Qualified Health Plans.
  • Experience with or knowledge of Medicaid 8001 file processing or any other inter-agency transactional file processing.
  • In-depth understanding of EDI 834 enrollment transactions, including Adds, Changes, Terminations, Cancellations, and error processing.
  • If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
    Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

    What is the career path for a Sr Systems Analyst - EDI - mPower Software Services?

    Sign up to receive alerts about other jobs on the Sr Systems Analyst - EDI - mPower Software Services career path by checking the boxes next to the positions that interest you.
    Income Estimation: 
    $128,913 - $157,494
    Income Estimation: 
    $151,561 - $188,748
    Income Estimation: 
    $71,714 - $96,112
    Income Estimation: 
    $107,566 - $124,747
    Income Estimation: 
    $84,966 - $118,118
    Income Estimation: 
    $144,138 - $187,517
    Income Estimation: 
    $96,072 - $129,026
    Income Estimation: 
    $151,682 - $176,424
    Income Estimation: 
    $118,709 - $163,786
    Income Estimation: 
    $144,138 - $187,517
    Income Estimation: 
    $69,178 - $79,954
    Income Estimation: 
    $83,745 - $96,702
    Income Estimation: 
    $71,714 - $96,112
    Income Estimation: 
    $144,138 - $187,517
    Income Estimation: 
    $84,966 - $118,118
    Income Estimation: 
    $131,462 - $151,444
    Income Estimation: 
    $96,072 - $129,026
    Income Estimation: 
    $144,138 - $187,517
    View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

    Job openings at mPower Software Services

    mPower Software Services
    Hired Organization Address Philadelphia, PA Contractor
    JOB DESCRIPTION The position requires expertise in analyzing software requirements for ambiguity, clarity, and completen...
    mPower Software Services
    Hired Organization Address Baltimore, MD Full Time
    Duties / Responsibilities Provide mobile platform design recommendations based on long-term IT organization strategy. De...

    Not the job you're looking for? Here are some other Sr Systems Analyst - EDI - mPower Software Services jobs in the Baltimore, MD area that may be a better fit.

    Senior Systems Architect - mPower Software Services

    mPower Software Services, Baltimore, MD

    Mobile Application Developer - mPower Software Services

    mPower Software Services, Baltimore, MD

    AI Assistant is available now!

    Feel free to start your new journey!