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Healthcare EDI Analyst

Hillcour inc.

Healthcare EDI Analyst

Tampa, FL
Full Time
Paid
  • Responsibilities

    Job Description

    Do you want to be part of an innovative and growing company who is a leading provider within the Healthcare space? Continental Benefits is experiencing tremendous growth and is in need of remarkable employees.

    WHO ARE WE?

    Continental Benefits can best be summarized as the product of the best technology and most experienced, respected people in the industry. We are built to deliver very high quality service, new models of plan design and provider compensation, and complete access to data. We were founded in November 2013 and designed to help Plan Sponsors create truly sustainable health plans. We provide complete TPA services including national network access, UM, CM, DM and wellness and prevention programs. Achievement of sustainable change is what caused the birth of our company. Our investors recognized a need for a new approach to employee benefits administration that would leverage advancements in technology to eliminate waste, increase satisfaction, and reduce costs for plan sponsors.

    Continental Benefits has the tools and flexibility to be the administrator of choice for any client nationwide, with concierge customer service, custom networks, onsite service representatives, customized wellness offerings, onsite clinic integration, and a leading edge data management warehouse and reporting system. 

    Our people are our greatest asset, and it is their commitment to providing remarkable customer support that has driven Continental Benefits to its success. Continental Benefits is focused on developing our employees, understanding that our future success depends on the talent we hire today.

    Employees receive personal job satisfaction and purpose while working with Continental Benefits, as well as competitive compensation and employee benefits which consist of:

    Medical and Prescription Coverage Dental and Vision Coverage Life Insurance Short Term and Long Term Disability. 401(k) Retirement Plan with Company Match Paid Time Off Tuition Reimbursement 

    JOB SUMMARY

    The purpose of this position is to lead, support, and implement solutions for the organization’s EDI needs. 

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    • Responsible for understanding EDI transaction set structures and tracking changes to these structure
    • The EDI analyst will leverage EDI knowledge in claims, enrollment, eligibility, and financial systems. Gather requirements, perform analyses, implement solutions and track outcomes to ensure accuracy of all transactions
    • Other duties as assigned

    KNOWLEDGE, SKILLS AND ABILITIES

    • Strong appreciation and ability to handle confidential & sensitive information 
    • Takes initiative to resolve situations and to accomplish projects actions and tasks.
    • Excellent verbal and written communication skills
    • Strong customer relations, interpersonal skills
    • Ability to handle difficult situations tactfully and diplomatically
    • Independent judgment in decision making and problem solving
    • Ability to multi-task & anticipate potential needs/problems
    • Strong attention to detail

    QUALIFICATIONS

    • Strong knowledge of 837 EDI Format and processing
    • In depth knowledge of Other HIPAA/EDI X12 4010/5010 healthcare-related file formats including 820, 834, 835, 270, 271, 276, 277, 278, and 999 is required
    • Experience in Benefits Administration Systems
    • General understanding of the file transfer protocol (FTP) process and SQL
    • Fluent with commonly used EDI concepts, practices and procedures within the healthcare industry
    • Analytical and creative problem solving skills
    • Excellent organizational skills with the ability to manage multiple tasks and priorities
    • Leadership, communication, interpersonal skills coupled with strong customer driven orientation
    • Bachelor’s degree in a technical, business, or scientific related field

    WORK ENVIRONMENT / PHYSICAL DEMANDS

    This position is in a typical office environment, which requires prolonged sitting in front of a computer.  Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment.  May have occasional high stress when deadlines are approaching.   

    EOE M/F/D/V

      

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