Prime West Health System - Neighbor carying for Neighbor

Electronic Data Interchange (EDI) Analyst/Developer I - Claims

Position Title: EDI Analyst/Developer I - Claims

Department: Claims Administration

Reports To: Business IT Manager

Status: Full time, exempt

 

Summary: To provide or facilitate health care electronic data interchange (EDI) development/support of systems that directly or indirectly support operations at PrimeWest Health.

 

Essential Functions and Responsibilities:

1. EDI Development / Support

  • Provide programming, systems analysis, and systems design in support of Electronic Data Interchange (EDI) transactions
  • Manage the implementation of new EDI partner relationships and additional services to existing partners
  • Develop and maintain systems documentation relating to EDI information, policies and operating procedures
  • Provide input with regard to interfacing of various processing software
  • Participate in the architecture and design of the claims and claims related systems and their development
  • Ensure state and federal regulatory compliance with regard to EDI transaction sets

2. Provide technical support for all claims and claims-adjunct systems

  • Provide end to end support for claims and claims related activities, from submission of claims through the remittance process
  • Provide technical assistance with regard to claims and related system interoperability
  • Provide leadership in work groups to improve system functionality and to systemically resolve processing issues
  • Facilitate and monitor enhancements to standard HIPAA EDI transaction sets internally and with external vendors

3. General work requirements

  • Maintain a positive and professional image with internal and external customers and co-workers
  • Assume responsibility for maintaining and enhancing personal and professional development
  • Strict adherence to PrimeWest Health policies and procedures with regard to the handling of protected health information (PHI)
  • Report acts of negligence or misconduct of other staff, especially with regard to violations of confidentiality rules to Department Director or CEO
  • Attend all mandatory meetings, department meetings and educational programs as directed
  • Serve as PrimeWest Health representative on external committees as requested
  • Travel may be required


Knowledge, Skills and Abilities:

  • Four (4) or more years experience with ANSI X12 EDI transaction sets in the healthcare industry
  • 4 year degree from an accredited college or university. Work experience can be substituted on a year for year basis
  • Knowledge of file transfer communication (e.g.,FTP)
  • Understanding of a relational database (e.g., Oracle, SQL, DB2)
  • Programming experience including Java or C++ highly desired, but not required
  • Proficient in Microsoft Office applications, including Excel and preferably Access
  • Must possess effective oral and written communication skills including ability provide effective training in one-to-one or in group settings
  • Ability to work well with PrimeWest Health employees and external customers
  • Ability to adapt to varied situations requiring constructive thinking analysis, interpretation and evaluation
  • Judgment and decision making in a calm, logical, technical, timely and accurate manner
  • Must be detail oriented and self-motivated
  • Ability to be flexible and prioritize work

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Qualified candidates should submit their resume and cover letter to:

Attn: LaDeen Schillinger
Alexandria Work Force Center
303 22nd Ave W, Ste 107
Alexandria, MN 56308


Will accept resumes through January 2, 2009. EOE
Please no phone inquiries.