EDI Data Analyst- Lead

What are we looking for in our EDI Data Analyst- Lead?

Job Title: Data Analyst- Lead

Location: Mason, OH

Bill Rate: $48-$53 per hour DOE

W2 contract duration: 12 contract with possible Extension

Job Summary:

The Medicaid EDI Manager will be responsible for overseeing Medicaid encounter feeds and ensuring the successful implementation of new client or state outbound transactions. They will play a key role in developing requirements, interpreting Companion Guides, and identifying process improvements in the EDI system. The Manager will also handle the analysis of encounter edits, rejections, and work with internal/external teams to improve data quality and submission timeliness.

Responsibilities:

• Implement new client and/or state outbound Medicaid transactions.
• Develop requirements based on stakeholder meetings and interpretation of Companion Guides.
• Identify, recommend, and implement process improvements to support the EDI system.
• Research and analyze encounter edits or rejections for Medicaid clients and collaborate with internal and external teams to resolve issues.
  
  

Qualifications:

• Strong knowledge of Medicaid encounter feeds and Companion Guides.
• Proven experience in EDI systems and transaction implementation.
• Ability to analyze and resolve encounter data issues.
• Familiarity with compliance requirements such as HIPAA, fraud prevention, and security standards.
  
  

Required Courses for Temporary Employees:

• General Compliance
• HIPAA
• Fraud, Waste, and Abuse
• Security Essentials
• Introduction to Phishing
  
  

Additional Training Required:

• Model of Care
• ODAG
• FSL Fraud Integral Staff Training
• CA Fair Claims
  
  

Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

Rate/Salary: $48-$53