RCM Technologies EDI Analyst in Bedford, Massachusetts
Reference # :18-00485Title :EDI AnalystLocation :Bedford, MAPosition Type :Direct PlacementExperience Level :Start Date :06/22/2018 DescriptionRCM Technologies is a leading provider of IT Business Solutions and Professional Engineering Services to over 1,000 clients in the commercial and government sectors. RCM partners with clients to define, implement, and manage a broad range of technologies across multiple platforms, systems, and networks. Our broad geographic presence ensures that a proven and reliable tactical and strategic capability is available and deployable virtually everywhere in North America. RCM Technologies is looking for a EDI Analyst this is a contract position in Bedford, MA.Implementations team is responsible for the electronic setup, testing and go-live of IT projects that involve Client Claims Processing. These claims may be received either via EDI (Electronic Data Interchange) or via Web Services (near real time technology). Each implementation analyst will work on multiple cross functional projects teams and will complete setup and testing tasks related to client implementations, EDI business maintenance work and UAT projects. An implementation analyst will work closely with other including Sales and Account Management, Project Managers, Production Support, Application Development & SQA.JOB ROLES AND RESPONSIBILITIES:* HIPAA compliance on implementations and Providing HIPAA-compliant guidance to trading partners requesting information about MPI requirements and industry standards for EDI protocols.* Ensuring confidentiality and privacy on all external communication.* Following established processes and rules on all implementation related activities as previously documented or covered in new employee training* Work on standard as well as custom, non-standard projects on a daily basis including implementing clients who send proprietary format claim files* Participating in daily internal and client facing conference calls* Reporting on implementation status and answering technical questions, on client calls* Bringing attention to lessons learned and issues found, on internal calls* Completing client setup on multiple internal applications for an implementation* Multiple projects may need setup concurrently* Must be completed in a timely manner in keeping with project deadlines* Detailed testing Conduct necessary testing and in-depth analysis on client test files* Communicate and resolve any potential issues prior to rolling trading partners into the production environment* Completing implementation monitoring after production rollout and prior to closing out a project* Manage the monitoring requirements of clients on a daily, weekly and monthly basis* Monitor, audit, and report on the processing of claims in production to confirm successful go-live* Proactively prioritize, communicate, and resolve any EDI process or system issues* Partner with other IT teams to implement enhancements and defect fixes* Providing clarification on implementation team or client requirements* Completing testing for successful sign off * Implement process improvements to enhance the efficiency of EDI processes* Use access to data and personal observation to identify potential process improvement opportunities.* Present potential solutions to management and other team members* Incorporate feedback and implement solutions. Report progress & measurements of success to management* Support Account Management and clients on claims processing report requirement* Perform routine and ad hoc analysis of EDI processing including but not limited to claim turnaround times, data mapping and claim flow issues o Write and execute queries to pull production data on claim volumes and specific scenarios* Prepare and maintain documentation that defines operational procedures, describes client requirements, and shares relevant analysis outcomes with internal and external stakeholders* Support Manager with team goals and corporate strategies as well as assist with the training and coaching of Level I staff* Provide coverage for other team members as needed on their vacations and support junior members * Consistently performing dynamic implementations environment* Understanding changes in processes and adopting them on open projects quickly* Understanding application rules and changes and ensuring correct setupJOB REQUIREMENTS* Bachelor's Degree in a related discipline or the equivalent combination of work experience and technical training* 3+ years progressively responsible experience in a related technical role* Exposure to, and general understanding of, Healthcare claims processing* Clear understanding and working knowledge of:o General EDI concepts and termso File transfer protocols (FTP)o HIPAA EDI protocols* 837P and 837I knowledge is critical* Strong knowledge of HIPAA EDI 5010 X12 Transactions such as 837, 997, 999, 834, 835, 277, 271 - This includes ability to read, edit and work with these files* Excellent verbal and written communication skills (must be clear, concise and grammatically correct)* Exceptional analytical and troubleshooting skills* Demonstrated ability to multi task and handle multiple projects and requests at once* Ability to effectively prioritize tasks and manage time in a dynamic environment to meet deadlines is required* Aptitude for self-learning and quickly assimilating new applications, processes and technologies* Experience in SQL scripts and creating queries preferred* Proficiency in MS Word, Excel and Outlook* Ability to work independently and as a member of a teamRCM Technologies is an Equal Opportunity Employer and does not discriminate on the basis of race, national origin, religion, color, gender, sexual orientation, age, non-disqualifying physical or mental disability or any other basis covered by law. Employment decisions are based solely on qualifications and business need.