EDI Technical Analyst (Claims) Job at Blue Cross Blue Shield of Arizona (Phoenix)

Job Description

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.

Job Responsibility

Develops technical documentation, designs, analyzes, tests, provides end user support and training for new applications and data structures
provides post-implementation review for systems and reporting to support customers and management
assist with analysis required for all Trading Partner EDI and flat files
Track and resolve basic or routine processing problems
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
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 text execution
Participate in defect review meetings
Develop and maintain SQL queries to test results and to create mock up data for testing and reporting
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
Research and analyze application procedural problems and provide recommendations for improvements and changes
Develop functional & technical specifications, logic flows and other documentation
Create Mapping Documents to move data between systems
Synthesize complex or diverse information
Review computer system capabilities, workflow and scheduling limitations
Translate business needs into technical solutions
Participate in maintaining operational and disaster-recovery procedures
Write or modify procedures for internal use, operational procedures, and computer operations
General understanding of cloud platforms, including AWS, Azure, kubernettes
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)
Participate in on-call rotation
Perform all other duties as assigned

Requirements

1 year of college-level coursework in system requirements design and interpretation and/or support of production systems (Level 1)
3 years of experience in computer technology and/or information systems (Level 2 – 4)
2 years of experience in data analysis, data management and integration, extracting and analysis reporting. (Level 2-4)
2 years of EDI experience (Level 1)
High-School Diploma or GED in general field of study (All Levels)
Intermediate skill in use of office equipment
Intermediate PC proficiency
Intermediate proficiency in spreadsheet, database, flow charting, and word processing software
Intermediate knowledge of data mapping techniques and data analysis software
Intermediate knowledge of computer operating systems
Intermediate knowledge of Microsoft Applications and Suites, Windows Server, and Microsoft SQL databases
Strong analytical skills to support independent and effective decisions
Ability to rapidly pick up new technologies
Ability to prioritize tasks and work with multiple priorities
Perseverance in the face of resistance or setbacks
Effective interpersonal skills
Verbal and written communication skills
Systems research and analysis
Demonstrate the ability to stay current on global threats and vulnerabilities
Experience working with and managing third parties
Knowledge of business requirements development and user acceptance testing
Maintain confidentiality and privacy
Analytical knowledge necessary to generate reports
Understanding of data governance best practices and data quality improvement principles

Nice to have

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
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
Bachelor’s Degree in Computer Science, Information Systems, Business, or related field
Knowledge of HIPAA regulations
Advanced proficiency in spreadsheet, SQL queries, database, flow charting, and word processing software
Advanced knowledge of data mapping techniques
Advanced knowledge of computer operating systems
Advanced knowledge of decision support systems
Advanced knowledge of programming, database systems, and data management
Advanced knowledge of the Edifecs EDI platform
Advanced systems research and analysis expertise
Impeccable project management skills
Solid technical ability and problem solving skills
Knowledge of internal departments and operations
Strong technical documentation skills
Ability to provide mentoring and peer review to junior team members
Ability to build lesson plans and deliver lessons to junior team members

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EDI Technical Analyst (Claims)

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