Data Exchange Analyst, Medical, Dental & Vision

📋 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, including employers, providers, and other TPAs.

• This position emphasizes the technical facets of data integration, file transformation, error resolution, and the continuous monitoring of data feeds for medical, dental, and vision claims.

• Create and implement data validation rules and processes to guarantee the accuracy, completeness, and consistency of exchanged data.

• Actively monitor system status and Data Exchange management data to swiftly identify potential irregularities that may affect quality and accuracy.

• Examine data trends to pinpoint potential issues or areas for enhancement.

⛳️ Requirements

• A Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or a related discipline. Equivalent professional experience may be accepted.

• 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 utilized tools in the healthcare sector (e.g., EDIFECS).

• Over 2 years of experience in data analysis, data integration, or EDI (Electronic Data Interchange) specifically within the healthcare field.

• Comprehensive 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 intricate business issues to uncover and resolve root causes.

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

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

• Self-driven and meticulous problem solver.

• Capacity to manage multiple competing priorities in a fast-paced environment and collaborate within a team.

🏝️ Benefits

• Health insurance

• 401(k) matching

• Paid time off

• Flexible work arrangements

• Professional development opportunities