About The Position

The EDI Encounter Analyst will be responsible for implementing, managing, and troubleshooting EDI systems for healthcare data exchange, with a specific focus on patient encounter data. This role requires working with trading partners to ensure data accuracy and compliance with industry standards, as well as resolving issues in data exchange. The analyst will handle various EDI transaction types related to patient data, claims, and encounters.

Requirements

  • 10+ years of IT experience
  • Recent healthcare payer insurance experience
  • Recent 3 – 5 years of experience in implementing, managing, and troubleshooting EDI systems for healthcare data exchange, specifically focusing on exchanging patient encounter data
  • Solid understanding of EDI concepts, standards, and protocols (e.g., HIPAA, ANSI ASC X12)
  • SQL Expertise - including Stored Procedures
  • Strong communication and interpersonal skills

Responsibilities

  • Work with trading partners to ensure data mappings and EDI transactions are accurate and comply with industry standards.
  • Identify and resolve issues in data exchange, ensuring data accuracy and integrity.
  • Handle different types of EDI transactions, such as 837, 838, 997, and others related to patient data, claims, and encounters.
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