EDI Technical Analyst (EDI 27X) - Hybrid

Job Title

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

• Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
• Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
• Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
• Onsite: daily onsite requirement based on the essential functions of the job
• Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This position is Hybrid within the state of AZ only. This Hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.

Purpose Of The Job

• Develops technical documentation, designs, analyzes, tests, provides end user support and training for new applications and data structures; and provides post-implementation review for systems and reporting to support customers and management. This position will be expected to assist with analysis required for all Trading Partner EDI and flat files.

• Real time EDI 27X experience required

Required Qualifications

Required Work Experience

• 1 year of college-level coursework in system requirements design and interpretation and/or support of production systems (Lev 1)
• 3 years of experience in computer technology and/or information systems (Lev 2 – 4)
• 2 years of experience in data analysis, data management and integration, extracting and analysis reporting. (Lev 2-4)
• 2 years of EDI experience (Levl 1)

Required Education

• High-School Diploma or GED in general field of study (All Levels)

Required Licenses

• N/A

Required Certifications

• N/A

Preferred Qualifications

Preferred Work Experience

• 2 years of experience in computer technology and/or information systems (Level 1 -2)
• 2 years of experience working in healthcare-related systems as a business / systems analyst or programmer (All Lev)
• 2 years of experience with 27X, 834, 835 and 837.
• 5 years of experience in data analysis, management, integration and reporting (Levels 3 – 4)
• 3 years of experience working in corporate enterprise-level systems as a business or systems analyst or programmer (Levels 3 - 4)

Preferred Education

• Bachelor's Degree in Computer Science, Information Systems, Business, or related field (All Levels)

Preferred Licenses

• N/A

Essential Job Functions And Responsibilities

Level 1 – Entry-level role; Performs job functions under close supervision or peer review

• Track and resolve basic or routine processing problems, coordinating with all areas.
• Research, analyze, track and resolve basic production problems.
• Develop business objectives, processing requirements, and technical specifications.
• Analyze files and map data from one system to another.
• Responsible for production cycles, solving production incidents and notification of problems.
• Write SQL queries needed for production support.
• Ability to query Splunk and App insight for logging results.

Quality Assurance

• Develop basic test data.
• Process test files and analyze test results.
• Create test files
• Able to use standard API testing tools like SOAP UI or Postman
• Perform execution of test cases/scripts; document results, log defects, and regression testing of defects.
• Perform test execution and defect reporting utilizing testing tools.
• Assist with root cause analysis and triage of key/critical defects for quick turn-around.
• Monitor and track traceability of business requirements to test execution.
• Participate in defect review meetings to explain and/or demonstrate defects.
• Develop and maintain SQL queries to test results and to create mock up data for testing and reporting.

Technical Analysis

• Assist with technical and data centered research required to produce and test Trading Partner files.
• Understand and apply TR3, Core CAQH and Blue Exchange rules.
• Learn business and systems data and process flows; and how they affects surrounding systems and operational areas.
• Research and analyze application procedural problems and provide recommendations for improvements and changes.
• Develop functional & technical specifications, logic flows and other documentation as applicable.
• Create Mapping Documents to move data between systems
• Synthesize complex or diverse information, collect and research data, use intuition and experience to complement data, work flows and procedures.
• Review computer system capabilities, workflow and scheduling limitations to determine if requested application or application change is possible within the existing system.
• Translate business needs into technical solutions with knowledge of programming languages (SQL, C# or VB.net, ETL, SOA, and OLAP).
• Participate in maintaining operational and disaster-recovery procedures.
• Write or modify procedures for internal use, operational procedures, and computer operations, as applicable.
• General understanding of cloud platforms, including AWS, Azure, kubernettes

Project Management

• Participate on small to large scoped projects.
• Use sound project management methodology and demonstrate solid time management skills.
• Create and deliver presentations.
• Monitor and create priority list(s) that are agreed to by user management.

Level 2 - Performs job functions with general supervision and peer review

• Research, analyze, track and resolve moderately complex production problems.
• Work with IT Infrastructure team to develop and implement effective production monitoring. Including balance and control dashboarding, monitoring and alerting of API's, data loads, Trading Partner transactions and any other process required to ensure our customers get the data required.
• Working knowledge of specific trading partner process flow.
• Working knowledge of various application integration for EDI. i.e. Portal, IVR, console apps, etc.
• Research transactions to troubleshoot issues or analyze for data trends.
• Ensure the department leverages internal tools and applications effectively.
• Build, support, and maintain moderately complex processes, programs, and data.
• Participate or lead medium to large scoped projects.
• Create moderately complex ad-hoc reports for internal usage and external usage.
• Develop project plans, time estimates and project schedules based on prioritization and business requirements.
• Research and become proficient in one or more applications or data marts.

Level 3 - Performs job functions with moderate supervision