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EDI Analyst
| Company | AltaMed Health Services |
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| Location | Montebello, CA, USA |
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| Salary | $82218.24 – $102772.8 |
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| Type | Full-Time |
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| Degrees | Bachelor’s |
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| Experience Level | Mid Level |
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Requirements
- Bachelor’s degree or equivalent experience required.
- Minimum of 4 years of managed health care experience is required; preferably working for a Health Plan or Managed Services Organization.
- Minimum of 2 years working with ASC X12 837 files, specifically 837P, 837I, 837D, 277CA, 999, TA1.
- Minimum of 2 years generating and submitting healthcare EDI files and a working knowledge of SQL databases and queries.
- Prior knowledge of ICD-10, CPT, HCPCS, NDC coding, and experience working with an EDI Clearinghouse(s).
- Familiarity with healthcare lines of business – Medicare, Medicaid, and Commercial – is a plus.
Responsibilities
- Generate EDI 837P/I/D encounter files (containing adjudicated claims data) in the format specified by Health Plan partners, DHCS, or designated third parties.
- Deliver files and manage the response files received to ensure that encounter files are processed in compliance with Health Plan guidelines and state and federal standards.
- Participate in Health Plan meetings as an Encounter SME if asked.
Preferred Qualifications
- Familiarity with healthcare lines of business – Medicare, Medicaid, and Commercial – is a plus.
