Techgene Solutions
Irving, TX
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Job Description :
Job Title: EDI Business Analyst
Location: St Louis, MO
Contract to hire position
4-6 Months Contract to Hire.

Must have to accept full time after 4-6 Months.

The Senior Encounter Data Analyst will be responsible for using critical thinking skills to provide actionable information and data to a variety of constituencies within the healthcare space. This role is responsible for handling all aspects of the CMS EDS and RAPS processes within the organization. Thorough knowledge of ANSI X12 EDI transaction sets including 837, 999, and 277 along with CMS MAO files is critical for this role. The individual is responsible for working with internal and external stakeholders in conceptualizing business questions, completing complex analyses, and interpreting and disseminating results to key audiences in a manner appropriate to each audience.

Description:
Roles and Responsibilities
Monitor the submission of claims data through the CMS Encounter Data process.
Resolve all EDI (999, 277) and CMS (MAO) errors.
Maintain the SQL code necessary to process claims through the Encounter Data process and make any necessary enhancements.
Handle the creation of RAPS files and submission to CMS along with processing of RAPS return files.
Create and present data findings that will be used by Claims and leadership to ensure that all EDS and RAPS data is accurate and complete.

Experience Qualifications, and Education
Bachelors or Master’s Degree in Healthcare, Mathematics, Computer Science, related field, or relevant experience.
4+ years of EDI experience relating to CMS Encounter Data.
5+ year of experience with SQL query writing within a Microsoft technology environment.
Demonstrated proficiency with all MS Office presentation applications including PowerPoint, Word, and Excel.
Strong aptitude for critical thinking and demonstrated data skills.
Experience working with large transactional databases and data warehouses.
Excellent verbal and written communication skills.
Ability to manage multiple tasks with shifting priorities.
Detail oriented; able to work independently and set priorities.
CMS institutional claims billing experience preferred.

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