EDI Analyst (Open to hiring at Sr. level)

Des Moines, IA - USA

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

Responsible for implementing tactics to achieve Electronic Data Interchange (EDI) strategies by working with multiple business areas and other IT professionals to document requirements develop test and implement electronic transactions with business partners. Support ongoing maintenance of these transactions and troubleshoot and resolve issues that arise. Maintain and support electronic transactions and/or applications by possessing knowledge of the organizations systems business processes as well as current technology advances and IT capabilities. Responsible for building and maintaining relationships with payer and clearinghouses/submitters.

Qualifications :

Required:

Bachelors Degree or direct and applicable work experience
Minimum of 1 years experience in technical business analysis
Experience with electronic eligibility claim status billing pre-authorizations claims and payment remittance transactions
Experience with ANSI X.12 compliant EDI transactions including 820 270/271 276/& 835s
General knowledge of programming and software development processes
Knowledge of system development life cycle methodologies including testing coordination
Knowledge and understanding of business dynamics
Knowledge of high level project management methodologies
Strong communication and listening skills
Ability to ask questions to understand others issues
Ability to build and maintain relationships based on trust
Ability to see a task through to completion independently and as a team member
Strong analytical problem solving skills; break problems apart systematically to understand the root cause
Ability to organize time and priorities to achieve business results
Ability to make decisions aligned with Wellmark policies systems and processes

Additional Information :

Job Responsibilities

a. Ensure EDI implementation projects are analyzed planned developed compliant tested and completed.

b. Create test transactions run tests find errors and confirm business requirements are met. Capture testing results in a test plan that compares expected to actual results.

c. Participate in industry workgroups to help define the implementation of ANSI X12 transactions and ensure Wellmarks compliance with the HIPAA X12 guidelines.

d. Support and adhere to Wellmarks software development lifecycle (SDLC) operational and development procedures and security standards.

e. Assist other Technology EDI staff in determining best practices for business process improvement to positively impact level of service.

f. Collaborate with EDI team and Electronic Commerce (EC) Solutions to understand and set direction for EDI transactions.

g. Manage the day-to-day EDI relationships between Wellmark and submitters.

h. Provide assistance to project managers in project administrative tasks including project reporting and documentation.

i. Identify and report deliverable status and/or issues to project manager and leader. Communicate accurately and concisely in a forum appropriate to the audience.

j. Establish and build working relationships with IT and business teams. Actively listen to others ideas; share information and ideas to help team reach goals.

k. Provide exceptional service for our stakeholders ensuring timely and accurate results.

l. May organize EDI marketing efforts with submitters.

m. Other duties as assigned.

An Equal Opportunity Employer

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Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at

Please inform us if you meet the definition of a Covered DoD official.

At this time Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes but IS NOT LIMITED TO: F1-OPT F1-CPT H-1B TN L-1 J-1 etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants

Remote Work :

Employment Type :

Full-time

Qualifications :

Required:

Bachelors Degree or direct and applicable work experience
Minimum of 1 years experience in technical business analysis
Experience with electronic eligibility claim status billing pre-authorizations claims and payment remittance transactions
Experience with ANSI X.12 compliant EDI transactions including 820 270/271 276/& 835s
General knowledge of programming and software development processes
Knowledge of system development life cycle methodologies including testing coordination
Knowledge and understanding of business dynamics
Knowledge of high level project management methodologies
Strong communication and listening skills
Ability to ask questions to understand others issues
Ability to build and maintain relationships based on trust
Ability to see a task through to completion independently and as a team member
Strong analytical problem solving skills; break problems apart systematically to understand the root cause
Ability to organize time and priorities to achieve business results
Ability to make decisions aligned with Wellmark policies systems and processes