EDI Solutions Quality Assurance Analyst
About The Position
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Have you been working with Utilization Management systems and/or Claims Payment systems and their associated HIPAA X12 EDI 278 Authorization transactions? Are you looking for an opportunity to expand your experience working with authorization data integrations in the health care industry? We have a great opportunity for an individual to provide quality assurance testing of our trading partner integrations from end to end working with our proprietary Medical Management system (MMS) and connecting it to a variety of Claims systems (FACETS, IDX, Xcelys and IKA, just to name a few) via an EDI 278 integration services in both Real-Time and Batch mode. The EDI Solutions Quality Assurance Analyst ensures that the technical integration between the MMS and Claims systems is seamless to our end users for all Authorization Data using an EDI 278 transaction. Our technical environment includes an Azure cloud-based database solution where we talk to a PostGres SQL databases for our core application database technology along with leveraging Snowflake SQL to interact with our reporting data warehouse for conducting EDI 278 statistical analysis on the health of our EDI 278 integrations as well as conducting deep dive transaction research for troubleshooting integration issues. You will use your existing database SQL skills to broaden your understanding of the required data mapping necessary to stand up the EDI 278 transaction for our trading partners. Can you articulate and interpret business requirements and test and validate those requirements are met. If this sounds like what you have been doing and something you want to continue to build upon your existing in-depth knowledge of how authorization data works in health care, please read on and apply as we have an opening on our team and would like to hear from you about your existing specialized experience in this space. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Requirements
- 2+ Years of experience in each of the following:
- Solid knowledge and experience with user acceptance testing processes
- Experience within the healthcare data environment – authorization, eligibility, provider, claims, etc
- Healthcare EDI Transactions Knowledge and Experience
- Healthcare IT experience
- Experience with data mapping and workflow documentation.
- Experience with SQL (manipulating data and queries) - Relational databases like MySQL, MS SQL, DB2
- Experience using Microsoft Word (creating and editing documents), Microsoft Outlook (email and calendar), Microsoft Excel (pivot tables, formulas (vlookup, xlookup, match, etc..) and Microsoft Visio (process/data flow diagrams) and Microsoft Teams
- Demonstrated ability to multi-task in a very intensive Email, Teams Chat, Service Now Ticketing System and Meeting environment while continuously managing user acceptance testing activities.
Nice To Haves
- Experience working with cloud-based solutions and services
- EDI 278 authorization data testing and validation experience
- Knowledgeable about claims billing practices and process management concepts – this may include knowledge of CPT coding or reimbursement processes, 3rd party provider enrollments, claims submissions, EDI 278 and HIPAA transactions and/or accounts receivables
- Demonstrated ability to read and write clear technical and functional specs for authorization data integration services
- Solid organization skills and attention to detail – this is very critical skill requirement.
- Excellent communication skills, both verbal and written, with the ability to interact with various levels of resources internally and externally.
Responsibilities
- Provide quality assurance and support of Programs/Products as assigned
- Facilitate the coordination of user acceptance testing efforts and defect resolution
- Create and execute test case scenarios for our EDI 278 authorization data integration services
- Log, track and summarize testing acceptance criteria results
- Perform implementation and regression testing activities as assigned
- Prepare and update program documentation, job aides, and other artifacts as requested
- May involve some interfacing with clients, managed care customers, IT resources and others when needed
- Assignment of special projects as needed
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
