Enrollment Source EDI Analyst
Denver, CO

Job Description

ABOUT THIS JOB

Our Operations Team ensures that we have the right infrastructure in place to support our corporate offices, Care Partners and Members. As an EDI (Electronic Data Interchange) Analyst, you will work with internal and external partners to increase electronic transactions and improve accuracy, leading to decreases costs and greater ease of working with Bright Health for our Members and Care Partners.

ROLE RESPONSIBILITIES

* Responsible for federal marketplace (FFM) enrollment source EDI processing and data reconciliation
* Reviews and actions all enrollment source specific reports
* Performs EDI analysis, research, and documentation of transactional data set requests and issues from internal and external customers
* Documents and manages tickets associated with EDI problems
* Provides technical support during and after implementation for healthcare electronic data interchange applications
* Provides analysis, support and guidance on complex electronic data transfers covering enrollment, premium billing statements and payments
* Reviews existing EDI processes, procedures and systems to improve submission rate and improve the quality of each encounter with EDI
* Establishes EDI standards, policies and procedures and champions them throughout the organization
* Acts as a subject-matter resource to enrollment and premium billing team
* Other duties and responsibilities as assigned

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

* One year experience with enrollment EDI operations and analysis in a healthcare industry
* Strong experience with 834 enrollment processing
* Experience handling EDI transactions coming from federal marketplace (FFM)

PROFESSIONAL COMPETENCIES

* Expert knowledge of EDI X12 and standard industry concepts, practices, and procedures for processing enrollment dat
* Demonstrates extensive knowledge of electronic data concepts and systems including business processes and system analysis
* Superior analytical ability and aptitude to design and construct meaningful business reports, investigate problematic data to discover root cause, and ability to create remedial actions to accomplish desired business results
* Self-starter with the drive and motivation to identify and resolve enrollment issues with minmal direction
* Individual contributor but cross-functional team leadership skills are required

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.

ABOUT US

At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.

Bright Health is tripling its footprint in 2019 to offer a variety of health insurance plans to more individuals. Bright Health operates health insurance offerings across Individual and Family Plan segments and the Medicare Advantage space in Alabama, Arizona, Colorado, Ohio, New York and Tennessee.

We're Making Healthcare Right. Together.

We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!