Associate EDI Analyst

Berkley•Chesterfield, MO

About The Position

With guidance and direction, the Associate EDI Analyst serves as a single and consistent point-of-contact for MEC’s Electronic Data Interchange (EDI) partnerships. This includes establishing and maintaining collaborative relationships with data providers and working with them to onboard new accounts, managing updates to existing data interfaces, and resolving data quality and completeness issues. The Associate EDI Analyst is expected to document data issues, work with providers on resolutions, and accurately assess issues that need to be escalated. The Associate EDI Analyst also works collaboratively with EDI Technicians and MEC’s internal data consumers to assess and mitigate impacts of data quality and completeness issues on downstream processes and products. The Associate EDI Analyst may also contribute to automation, process, and data processing system improvements. The Associate EDI Analyst can expect to handle the more straightforward data files and is expected to perform analysis with guidance and direction from more senior team members. Key functions include but are not limited to: With direction, manages the receipt, mapping, transforming, and processing of data received from partners. Follows established protocols for acquiring, transforming, and mapping of data received from partners. Monitors the frequency and quality of data received from partners and escalates issues to management. Troubleshoots data mapping and processing issues. With direction, performs data analysis to determine root causes for and impacts of data quality issues. Ensures compliance with security and data privacy policies and procedures. Establishes and maintains collaborative relationships with data providers. Communicates technical procedures effectively and makes data exchange concepts understandable to both technical and business staff. Collaborates with account onboarding and business operations teams on the acquisition of data from providers. Reviews the effectiveness and efficiency of existing processes and recommends opportunities for automation and improvements. Assists in implementing process automation and improvements. With guidance, creates audits or other mechanisms to measure data quality and completeness. Prepares or updates specification documents for data providers.

Requirements

College or university degree in the field of computer science or business administration or equivalent experience.
Some direct work experience or familiarity with data analysis or in working with electronic data interchange or application programming interface protocols.
General understanding of medical or worker’s compensation claims processing.
Familiarity with medical claim standards such as 837I, 837P or similar medical claim data formats.
Familiarity with codes for medical procedures and diagnoses.
Knowledge of Electronic Data Interchange (EDI) protocols, with an emphasis on those prescribed by HIPAA and PPI.
Knowledge of data analysis methods and techniques.
Familiarity with data mapping and transformation processes and tools.
Proficient in using office productivity software (e.g., Excel, Word).
Familiarity with using source control tools for version control.
Experience working collaboratively with business partners and data providers.
Experience working in a team-oriented, collaborative environment.
Can consistently apply problem-solving skills.
Able to exercise professional judgment and to perform work with direction.
Able to effectively prioritize and execute tasks in a fast-paced environment.

Responsibilities

Manages the receipt, mapping, transforming, and processing of data received from partners.
Follows established protocols for acquiring, transforming, and mapping of data received from partners.
Monitors the frequency and quality of data received from partners and escalates issues to management.
Troubleshoots data mapping and processing issues.
Performs data analysis to determine root causes for and impacts of data quality issues.
Ensures compliance with security and data privacy policies and procedures.
Establishes and maintains collaborative relationships with data providers.
Communicates technical procedures effectively and makes data exchange concepts understandable to both technical and business staff.
Collaborates with account onboarding and business operations teams on the acquisition of data from providers.
Reviews the effectiveness and efficiency of existing processes and recommends opportunities for automation and improvements.
Assists in implementing process automation and improvements.
Creates audits or other mechanisms to measure data quality and completeness.
Prepares or updates specification documents for data providers.