EDI Business Analyst

ICRA Workflow Subject Matter Expert

This position will serve as the Subject Matter Expert for the Individual Coverage Health Reimbursement Arrangement (ICRA) workflow. The role involves managing individual plan data to ensure smooth enrollment and coverage, partnering with internal and external teams to troubleshoot processes, and supporting the implementation of new channel partners. The ideal candidate will monitor incoming data to maintain accuracy and timeliness while responding to various inquiries related to member records and enrollment.

Key Responsibilities

• Act as the Subject Matter Expert for the ICRA workflow.
• Manage individual plan data to ensure smooth enrollment and member coverage.
• Partner with internal teams and external channel partners to troubleshoot and improve processes.
• Assist in the implementation of new channel partners by working with IT and conducting testing.
• Monitor incoming data via API or electronic files (e.g., 834/820) to ensure accuracy and timeliness.
• Respond to inquiries regarding member records, enrollment issues, and partner onboarding.
• Handle membership inquiries and the implementation and decommissioning of partners.
• Ensure members have access to care by monitoring data accuracy and resolving issues.

Required Qualifications

Technical Skills: Proficiency with Microsoft Excel, Word, and PowerPoint is required.

Work Environment

The position is remote and candidates must be based in Colorado or California, working Pacific or Mountain Standard Time hours.

We are an equal opportunity employer and welcome applications from all qualified candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.