Senior Systems Analyst (1 Award, Submit 2 Candidates)
Description: Health Care System Experience Preferred
The scope of this effort is for the candidate to provide EDI data analysis and support services for the Maryland Health Benefit Exchange (HBX) system.
Required Skills/Duties, but not limited to:
- Work within the EDI Operations team under the IT Project Management Office (PMO) to provide all EDI related services for the Exchange.
- Analyze EDI files from Carriers and identify the root cause for EDI file rejections.
- Coordinate with the development team, business operations team and the testing team to analyze, fix, test and retransmit the EDI files on a daily basis.
- Analyze the 999 files from the Carriers, perform root cause analysis for exceptions.
- Create data change request with the PMO, coordinate with the business team, analyze the error reports by accessing the database or application and perform root cause analysis for transaction rejections.
- Communicate with MHBE IT team, business team, vendor team and other stakeholders to translate business needs into EDI data fixes and solutions.
- Six (6) years of experience with EDI validation tools such as Edifecs, WTX, EDI X12 files.
- Six (6) years of experience with transactions sets such as 834, 999 and TA1, SOA, EDI and EAI Applications
- Strong knowledge in the Affordable Care Act (ACA) eligibility rules
- In-depth understanding of 834 enrollment transactions including Adds, Terminations, Cancellations and Life events
- Strong knowledge of DB2 database and SQL scripts
- Experience working with PMO processes, policies and procedures.
- Experience in quality assurance and quality control of a large scale Healthcare System. Windows.
Minimum Qualification Requirements:
- A minimum of four (4) years of experience with EDI validation tools such as Edifecs and WTX.
- A minimum of four (4) years of experience in creating EDI X12 files for different kinds of transactions sets such as 834/999/TA1.
- A minimum of four (4) years of experience in reviewing and understanding technical documents such as companion and implementation guides of Healthcare EDI formats 834 and 999
- A minimum of (4) years of experience in analyzing and testing SOA, EDI and EAI Applications
- Strong analytical and problem solving skills
- Excellent communication skills including the ability to understand and communicate technical information to business users, and gather business requirements that can be translated into technical requirements
- Experience with establishing and maintaining reporting databases and data warehouses
- Ability to manage multiple critical priorities and tight deadlines.
- Demonstrated analytical and problem solving skills.
Place of Performance: Linthicum, Maryland