EDI Analyst

Position : EDI Analyst

Location : Orange County, CA

Duration : 6 Months

Top Three Skills:

1. EDI
2. IDX or (Epic, Facets, Easy Cap)
3. HIPPA Standards( 277-999, 837, X12 Formats

Job Description:


Under minimal supervision, this position is responsible for administering all aspects of EDI setup, analysis, design, mapping, testing, troubleshooting and implementation. The position is responsible for the daily operational activities which will ensure successful and accurate inbound and outbound transmissions. Position is the primary contact for EDI Clearing houses and trading partners, and is responsible for EDI communication within the organization, to customers, and IT.


Essential Duty # 1 - Percent: 60


Administers all aspects of EDI and performs EDI setup, analysis, design, mapping, testing, troubleshooting, implementation and daily operational activities. Ensures all daily EDI and scripting processes are completed timely and accurately and accounts for all inbound and outbound files. Troubleshoots the EDI and scripting process for errors using EDI, 3rd party, communication (FTP) and application software. Reviews and monitors transmission notifications and resolves daily file errors and failures. Implements and coordinates routing changes requested by internal or external customers and determines necessary production turnover tasks, prepares required documents, and follows through to ensure smooth implementations are completed. Provides technical support to Business Units and other staff regarding EDI and scripting issues/inquiries. Uses scripting tools such as WinRunner, Boston Workstation, etc. to upload files to various databases.


Essential Duty # 2 - Percent: 25


Establishes and maintains open communications within the organization and with external clients and vendors. Answers client and vendor questions regarding file submission in a professional and timely manner and maintains EDI and scripting client transaction activities. Analyzes root cause of errors; communicates errors to the appropriate clients and trading partners; and escalates c errors, issues, or problems to Department Director. Works with IT to ensure effective infrastructure support is provided to maintain ongoing EDI operations.


Essential Duty # 3 - Percent: 10


Assists in the research and evaluation of additional Edi, file mapping, process improvement tools and capabilities required in support of clients needs. Identifies information requirements to improve business processes, and supports critical business strategies.


Essential Duty # 4 - Percent: 5


Completes varied projects of an analytical or tactical nature as assigned by management or identified through own work.


Performance Standards:


Support the vision, values, and mission of Prospect Medical Group. Be cooperative


and helpful to others within the employee's own department as well as support positive interdepartmental and programmatic communications and cooperation.


Qualification Requirements:


To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


Education/Experience:


Bachelor's degree in Information Systems or equivalent experience with at least 1-2 years related job experience or equivalent combination of education and experience. Minimum three years of Managed Health Care background preferred. Exposure and understanding of utilization of analytical development concepts and methodologies. Minimum 1-2 years experience with EDI, ANSI X12N 837 & 834 HIPAA standards, file layouts, scripting tools and ACCESS. IDX tool kit and HIPAA KIT for X12 translator experience preferred. Conceptual understanding and hands-on experience with various electronic trading mechanisms, such as FTP, PGP and FTPS. Working knowledge of relational databases and understanding of their application as it relates to EDI file upload. SQL preferred.


Extensive knowledge of all Microsoft software (Access, Excel, Word, Project, etc).


Syed Raza


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