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EDI Analyst

Zelis

Zelis

IT
Multiple locations
Posted on Thursday, June 27, 2024

Location and Workplace Flexibility

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

Position Overview

With Zelis, an EDI Analyst collects and stores data related to healthcare claim reimbursements, market research, logistics, linguistics, or other behaviors. They bring technical expertise to ensure the quality and accuracy of that data, then process, design and present it in ways to help people, businesses, and organizations make better decisions.

Key Responsibilities

  • Evaluate design and technical layouts for purposes of data mapping, integration analysis, scripting, testing and software conversion

  • Focus on new and supplemental implementations and change requests

  • Conduct full lifecycle analysis to include requirements, activities and design

  • In collaboration with the rest of the development team, ensure that the proposed solution addresses all of the client’s business requirements

  • Perform quality review checks on project deliverables

  • Import or Export, research and interpret ANSI X12 files coming from various sources. Formats include: 837I, 837P, 835, 834, 278 and 999

  • Communicate with payers to get clarification on requirements

  • Support application testing, implementation, and training activities

Qualifications

  • 3+ years of experience working with EDI transactions in a high- volume data processing environment

  • Knowledge of ANSI specifications (ANSI 834, 835, 837, 820, 277) and the ability to determine ANSI related problems/errors

  • Basic understanding of NACHA rules, policies, and operations that impact 835

  • Ability to learn other transaction types as defined by business needs

  • Ability to recognize issues, provide solutions, and drive positive change

  • Ability to work with stakeholders to assess potential risks

  • Ability to analyze existing tools and databases and provide software solution recommendations

  • Ability to translate business requirements into non-technical terms

  • Experience in methodologies and processes for managing large scale databases and relational databases

  • Understanding of metadata standards

#LI-RZ1

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.