Claims Analyst

United States·Southfieldmid

OtherAnalyst

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Quick Summary

Requirements Summary

Strong understanding of EDI transactions and claims processing Proficiency in SQL and data analysis Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica,

Technical Tools

OtherAnalyst

Job Title: EDI Claims Analyst
Job Location: Remote
Job Type: Contract

Job Description:

The EDI Claims Analyst is responsible for analyzing and processing electronic data interchange (EDI) transactions, including claims and eligibility inquiries. This role involves reviewing and resolving claim rejections, ensuring accurate data submission, and supporting various EDI transactions. The analyst will work closely with provider relations, IT, and other internal teams to ensure smooth and efficient claims processing.

Requirements

~1 min read

Strong understanding of EDI transactions and claims processing
Proficiency in SQL and data analysis
Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica, and Apigee
Familiarity with CBH systems, including Connects and Flexicare
Excellent problem-solving and analytical skills
Ability to mentor and train team members
Executive leadership client facing