EDI Analyst II
US-UT-Murray
University of Utah Health Care
Req #: 79824
Type: Full-Time
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Overview: *This position is open to a level I or level II EDI Analyst; the requirements for each level is listed below* As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA Under the guidance of the EDI Analyst Senior, this position provides technical support during and after the implementation of the health care Electronic Data Interchange (EDI) setups. Responds to inquiries regarding EDI issues with enrollment, claims, payments and/or clearinghouse activities. This position is not responsible for providing care to patients. Corporate Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system. Responsibilities: * Performs EDI setups of clearinghouse information and ACH payments to customers following specified procedures. * Maintains procedures as needed with appropriate updates. * Performs setups of data exchanges between entities for health plans. * Validates data locations from customer data feeds. * Maps data feeds into Health Plan formats. * Conducts analysis of EDI transactions for testing, setup and error correction. * Where appropriate, loads, monitors and tests incoming and outgoing EDI transactions in a timely manner. * Ensures the accuracy of data, analyzes conflicting data, works with partner entities to verify and resolve data errors. * Utilizes computer programs and software to analyze data and determine trends and changes in data proficiently. * Communicates in a professional manner (verbal and written) with customers and team members when there are problems or changes required. * Provides documents and reports to providers, colleagues, administrators and outside agencies as required. * Assists and/or works on projects as required. Knowledge / Skills / Abilities * Ability to use office desktop tools effectively (e.g. word processing, email, presentation software and spreadsheets). * Demonstrated ability to utilize spreadsheets to find trends or problems with data sets. * Knowledge of health insurance industry data and standards. * Knowledge of processes and procedures of various health plan claim flows from intake to provider payment. * Knowledge of Encounters and ability to monitor and audit transactions. * Demonstrated customer relations and effective communication skills. * Demonstrated analytical skills. * Demonstrated presentation skills. * Ability to work well alone or in a team setting. * Ability to perform the essential functions as outlined above. Qualifications: QualificationsRequired for Level 1 * Associate's degree, or equivalent experience in an IT setting. * Proficient in Microsoft business applications. * Experience in collecting, organizing, analyzing, and presenting data. Required for Level 2 * Associate's degree, or equivalent experience in an IT setting. * One year of experience with Health Plan EDI processes. * Proficient in Microsoft business applications. * Experience in collecting, organizing, analyzing, and presenting data. * Solid understanding of EDI ANSI X12 transactions.
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