RHI Careers

Description

POSITION SUMMARY The Business Systems Analyst, EDI, is responsible for design, development, and support of solutions for electronic data interactions with business partners. The Business Systems Analyst will engage stakeholders to: elicit and define business requirements; design, develop, and implement solutions that meet business needs; collaborate with cross-functional teams to develop integrated solutions; collaborate with internal and external business partners to design, develop, test and deploy these solutions; support production systems including analyzing and resolving production problems and end user service requests. The role requires building and maintaining relationships with internal business stakeholders and external business partners. The role requires advanced understanding of: EDI transactions and EDIFACT standards, EDI tools and technologies used across the industry, EDI and e-Commerce communication methods. The role will interface with multiple departments including Claims, Network Management, Utilization Management, and Finance. The role will interface with vendors, trading partners, and clearing houses. DUTIES AND RESPONSIBILITIES Design, develop, implement, and support EDI, and application integration solutions, including transactions to be exchanged between applications. Analyze EDI trading partner requirements and specifications. Coordinate and maintain trading partner relationships with existing vendors. Provide EDI expertise on initiatives where appropriate throughout the business. Primarily interacts externally with clients, vendors, third party EDI service suppliers and EDI software providers. Aid in the development and refinement of policies and procedures to support EDI operations processes. Maintain all EDI mapping documentation and vendor compliance manual regarding EDI information. Create testing methods and procedures to implement the flow of EDI financial transactions between trading partners and financial institutions, and complete the testing with trading partners. Develop custom data conversions and translations. Administer and support EDI processes and scheduling. Provide technical support to trading partners, internal business unites and application interface support regarding EDI transmission, mapping and EDI network issues. Identify and resolve EDI problems, including but not limited to, the detection and correct escalation of transmission issues. Maintain and review daily EDI systems reports, acknowledgment, communication, translation and performance. Reviews, tracks and ensures document transmissions take place as required by business needs in a timely manner while identifying and resolving day to day EDI systems and interfaces, connectivity and operations issues. Create test cases, execute tests, and resolve defects. Ability to prioritize independently, multiple requests and requirements to meet the organizational goals. o Analyze application defects to determine if they fall within scope of project requirements. o Work with the IS Operations team to validate test cases against all requirements Keep abreast of healthcare industry best practices and managed care regulatory requirements KNOWLEDGE & SKILL REQUIREMENTS Extensive knowledge of standard EDI healthcare data exchange structures (X12N, HL7, NSF, NCPDP, XML, and others) Expertise with important EDI documents (820, 834, 835, 837, HL7, 997) HIPAA compliance knowledge as it relates to healthcare data Knowledge of continuous quality improvement techniques Good grasp of the typical functionality of a core managed care system Strong organization, time management and project management skills and multi-tasking abilities Strong database-related development skills (complex SQL queries, comp
Qualifications:
Advanced EDI, None, None None.
EEO Statement:
With more than 100 locations in North America, Europe, Australia and Asia, Robert Half Technology is a leading provider of IT professionals on a project and full-time basis for initiatives ranging from Internet development and multiplatform systems integration to network security and technical support. A division of Robert Half International, we were ranked number one in our industry by Fortune magazine's America's Most Admired Companies, and included in BusinessWeek's 50 Best Performing Companies. To learn more about this job opportunity, contact us today at 1.800.793.5533. Robert Half Technology is an Equal Opportunity Employer. Apply for this job now or contact our branch office for additional information: