Data Exchange Analyst, Medical, Dental & Vision

This is a fully remote position, open to applicants in Colorado, +1 more state.

📋 Description

• The Data Exchange Analyst plays a vital role within our Data Operations team, tasked with ensuring the precise, efficient, and secure transfer of healthcare data between Capital Rx – JUDI Health and its diverse partners, which include employers, providers, and other TPAs.

• This position concentrates on the technical elements of data integration, file conversion, error resolution, and continuous oversight of data feeds for medical, dental, and vision claims.

• Design and implement data validation protocols and procedures to guarantee the accuracy, completeness, and consistency of the exchanged data.

• Actively monitor system performance and Data Exchange management data to swiftly detect any potential irregularities that could affect quality and accuracy.

• Examine data patterns to pinpoint possible issues or opportunities for enhancement.

⛳️ Requirements

• A Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or a similar field. Relevant work experience may be taken into account.

• Understanding of healthcare claim adjudication processes for medical, dental, and vision.

• Strong knowledge and familiarity with EDI SNIP validations and one of the most commonly used tools in the healthcare sector (e.g., EDIFECS).

• A minimum of 2 years of experience in data analysis, data integration, or EDI (Electronic Data Interchange), particularly within the healthcare industry.

• Solid understanding of healthcare EDI transactions (e.g., 834 Enrollment, 837 Professional/Institutional/Dental Claims, 835 Remittance Advice).

• Exceptional analytical, problem-solving, and critical thinking abilities.

• Familiarity with various file transfer protocols (FTP, SFTP, FTPS).

• Knowledge of HIPAA compliance and other pertinent healthcare regulations.

• Strong attention to detail and a dedication to data accuracy.

• Capability to analyze complex business challenges to identify and address root causes.

• Proficiency in SQL, Excel, JSON, and additional technical data skills is preferred.

• Excellent communication skills with the ability to build effective working relationships with both internal and external stakeholders.

• Self-driven and detail-oriented problem solver.

• Ability to manage multiple competing priorities in a fast-paced environment while collaborating in a team.

🏝️ Benefits

• Health insurance

• 401(k) matching

• Paid time off

• Flexible work arrangements

• Professional development opportunities