Carex is partnering with a WI based healthtech startup as the add a Healthcare EDI Data Analyst to their growing team. This hire will work with the data engineering and data integrity teams to support and enhance their current machine learning and advanced analytics solutions. This is a fully remote role with preference given to individuals who reside in WI.
The Healthcare EDI Analyst will serve as a primary resource for the intake of new healthcare EDI data. The ideal candidate will have an inquisitive nature and a thirst for getting to the bottom of data patterns, along with the technical expertise (SQL) to navigate healthcare EDI data in a relational database. We are looking for a candidate with 5+ years of experience in Healthcare EDI data and a degree in Computer Science, Healthcare or a related field. We are looking for someone who has domain expertise in one or more of the following: claims processing, enrollment, EDI transactions, eligibility, referrals and prior authorizations.
What You’ll Do
- Serve as a primary resource for intake of new Healthcare EDI data, including but not limited to:
- Matching claims submissions and remittances
- Helping define a target population through exclusions in the data
- Researching anomalies in the data
- Participate in ad-hoc data analysis (claims-based research)
- Assist with review and documentation of our existing code base and data flow
What You’ll Bring
- Proficiency working with Healthcare EDI transactions: 837 (I and P); 835
- 5+ years of experience querying and analyzing Healthcare Data (EDI required, but preference given to candidates who also have experience with EHR/EMR data out of a provider practice management system such as Epic or Cerner)
- Working knowledge of EDI healthcare transactions, including split transactions and claim numbering
- General knowledge of healthcare terminology
- Strong programming skills and the ability to write and understand complex SQL queries (for the purposes of data analysis and manipulation)
- Experience using a full suite of Microsoft Office Products
- Bachelor’s degree in CS, healthcare, or related field
- Experience working with cloud-based solutions and services (preference given to candidates with AWS, Snowflake)
- Solid organization skills and impeccable attention to detail
- Excellent communication skills, both verbal and written, with the ability to interact with various levels of resources
- Ability to utilize multiple channels of communication simultaneously throughout the workday and actively be engaged in meetings, working sessions and assigned project work
Preferences
The following are preferred for this role but are not requirements:
- Experience with claim denials
- Knowledge of CPT coding, diagnoses, DRGs
- Healthcare payer/provider experience
- Experience in mapping and translating data between EDI formats and proprietary systems
Carex Consulting Group is an equal opportunity employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, marital status, disability, gender identity or Veteran status.
#LI-LL1
#REMOTE