Sr. EDI Analyst

JOB SUMMARY: Position is responsible for the technical support of Electronic Data Interchange (EDI) processes. This includes the daily monitoring of EDI file processing, the troubleshooting of issues impacting successful receipt or delivery of client files, the setup and testing of new trading partners, and general customer support of issues called in to the Service Desk

JOB ROLES AND RESPONSIBILITIES:

1. Manage the technical efforts associated with implementing complex and high-profile EDI trading partners.

• Participate on weekly implementation calls or meetings with clients and vendors committed to establishing an EDI partnership with MPI.

• Share HIPAA-compliant expertise with trading partners requesting clarification on EDI standards, file mapping rules, and system logic.

• Ensure proper setup of the EDI tools and systems that support file transfer between MPI and new trading partners.

• Conduct necessary testing and in-depth analysis to resolve any potential issues prior to rolling trading partners into the production environment.

• Constructively present testing results and propose adjustments that will improve service delivery to our clients and strengthen our ongoing partnership.

• Monitor, audit, and report on the processing of newly implemented trading partners to confirm their successful transition to the production environment

1. Oversee the production support of high-profile EDI trading partners.

• Monitor the production environment and proactively prioritize, communicate, and resolve any EDI process or system issues.

• Support any issues that are raised or escalated through Account Management or executive leadership

1. Oversee the production support of high-profile EDI trading partners.

• Monitor the production environment and proactively prioritize, communicate, and resolve any EDI process or system issues.

• Support any issues that are raised or escalated through Account Management or executive leadership

1. Stay current with changing technical protocols and Healthcare regulations regarding data exchange.

• Continue to research and establish communication channels with industry-recognized organizations that provide EDI insights and direction (for example WEDI).

• Plan and incorporate new standards as appropriate.

• Offer clear and accurate interpretation of industry-driven changes to internal and external contacts when solicited.

• Proactively communicate updates to internal and external contacts as regulations dictate

1. Leverage technical expertise and communication skills to positively influence the direction of EDI technologies and processes within MPI and by our trading partners
2. Perform routine and ad hoc analysis of various facets of EDI processing including but not limited to system performance, claim turn around times, data mapping, and claim volumes. Partner with Applications Development or other operational areas to successfully implement enhancements or fixes that will provide value to our EDI clients
3. Communicate system and interface availability, modifications, and problems to internal and external stakeholders as needed and according to established policies and procedures
4. Implement process improvements to enhance the efficiency of the EDI processes.

• Use access to data and personal observation to identify potential process improvement opportunities.

• Communicate potential solutions to management.

• Implement solutions independently or collaboratively.

• Report progress and measurements of success to mgt

1. Support clients and trading partners with their non-standard requests for ad hoc reports, testing analysis and other technical deliverables
2. Provide direction to Level I and Level II staff.

• Coach staff needing assistance with production support issues.

• Provide implementation guidance.

• Help staff learn how to troubleshoot issues and practice effective analytic techniques.

1. Provide documentation that may be used for training or coverage gaps
2. Provide support to Manager.

• Work with Manager to define team goals and prepare for future EDI needs.

• Attend sales calls requiring EDI expertise or second level technical representation.

• Act as a backup for the Manager when needed.

• Assist Manager with team oversight and managing work effectively.

1. Provide coverage for other team members as needed; some on call support duties may be required on a part time or rotating basis.
2. Collaborate, coordinate, and communicate across disciplines and departments.
3. Ensure compliance with HIPAA regulations and requirements.
4. Demonstrate commitment to the Company’s core values.
5. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

Please note due to the exposure of PHI sensitive data – this role is considered to be a High Risk Role.

JOB SCOPE:

The incumbent relies on experience and judgment to plan and accomplish goals. The incumbent works under general supervision to review systems and provide technical support and assists with escalated issues.