Business Analyst I, EDI

American Specialty Health San Diego, CA
American Specialty Health, Inc. is seeking an experienced Business Analyst to join our growing EDI team. This person will work with business owners, IT managers, and developers to gather functional requirements for implementations, and maintenance of capitation and reconciliation.

You are invited to learn more about American Specialty Health's events on our events page.

Responsibilities:

* Provides research and support to internal stakeholders as EDI eligibility or claim processing relates to their functions.

* Triage incoming research and support requests from internal departments.

* Works with internal stakeholders to identify and resolve missing or incorrect data.

* Ticket management including response to first-level issues, triaging, prioritization, escalation, and assignment of tickets to appropriate EDI Software Engineer projects/teams.

* Uses ticketing system to track issues with may require system improvements or EDI Software Engineer intervention.

* Assists in creating user and/or training guides on applications.

* Assists in creating and maintaining a common EDI Knowledgebase.

* Documents system bugs, errors and solutions.

* Responsible for meeting weekly and monthly production requirements for timely and accurate support resolutions.

* Partner with cross functional teams to improve existing processes and create new work flows as needed.

* Provides production support to the EDI Team.

* Monitors file frequencies and timely receipt of data transmissions.

* Ensures timeliness of production processing to meet contractually obligated timelines and internal turn-around times.

* Responsible for working daily error queues for validation errors and file failures.

* Recognizes unique or problem situations and recommends solutions in conjunction with the EDI Manager.

* Document EDI processes and update standard operating procedures

* Performs other research as necessary in support of EDI production requirements.

* Assist EDI Software Engineers and QA with identification, documentation, mitigation and resolution of reported bugs.

* Supports EDI Team with new client implementations.

* Attends meetings and coordinates activities and preparation of related documents.

* Responds to calls, correspondence, and email as directed.

* Interacts with EDI management and other staff to provide or obtain information.

* Maintains follow up to ensure timely and accurate completion of assignments.

* May serve on committees, workgroups, and project teams as needed.

* Maintains confidentiality of all sensitive business information at all times.

* May serve on committees, workgroups, and project teams as needed.

Qualifications

* Bachelor's degree in Information Management, Business, or equivalent experience. If equivalent experience, high school diploma required.

* Familiar with or willing to learn software development, collecting systems requirements, and creating documentation.

* Minimum 2 years progressive experience in a managed health care, in project management, research, support or equivalent.

* Experience with all phases of the software development life cycle from requirements to the release and maintenance of enterprise level applications.

* Experience in software quality assurance and documenting test cases.

* Minimum 2 year experience in customer service.

* Solid experience writing SQL queries is required.

* Familiar with or willing to learn agile development methodologies.

* Experience with EDI files and formats in a healthcare environment.

* Proficient in MS Office

Core Competencies

* Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.

* Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.

* Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.

* Ability to effectively organize, prioritize, multi-task and manage time.

* Demonstrated accuracy and productivity in a changing environment with constant interruptions.

* Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.

* Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Physically capable to stand, sit, kneel, crouch, and climb. Capable of using hand tools and manipulation of small parts. Frequently lifting equipment up to 40 lbs.

Environmental Conditions

Usual office setting.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.

Please view Equal Employment Opportunity Posters provided by OFCCPhere.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.

* Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.

* Please view Equal Employment Opportunity Posters provided by OFCCP here.

* The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

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