Systems Analyst Associate - Remote Opportunity
New York, NY

Job Description

Job Description

General Dynamics Information Technology (GDIT) is seeking a Systems Analyst Associate to support our client. In this role, you will be administering all aspects of Electronic Data Interchange (EDI) activities including Coordination of Benefits Agreement (COBA) Crossover Process, Section 111, and Data Sharing Agreements with employers. You will also be responsible for troubleshooting and diagnosing issues with direct file transfer and issues experienced with the Coordination of Benefits Secure Website (COBSW). Addtiontally, you will be responsible for the front-line customer service support and education with Stakeholders.

This is a remote opportunity!

Responsiblities:

* Monitor the processing of files between mainframe and distributed system including compiling error reports and communicating with Trading Partners, programmers, Insurers, Employers, Medicare contractors, and CMS to resolve.
* Interact directly with stakeholders to resolve issues
* Work independently on assigned business partners with a minimum of supervision.
* Troubleshooting and facilitating the resolution of any identified data file transmission and transaction errors including verification that all communication links and interfaces are working correctly and communicating appropriately.
* Working with management to establish, document and maintain EDI procedures by identifying errors and taking corrective action, reconciling EDI transactions through coordination of information with internal and external customers, Accounting Department, IT Department and external vendors to maintain EDI integrity.
* Overseeing and maintaining the EDI Inquiry Problem database including the evaluation of problems or issues through to resolution.
* Conducting regular audits of EDI transactions to determine accuracy and areas for improvement and maintaining EDI maps and business rules for HIPAA validation software.
* Monitoring the daily receipts and processing of claim files from Medicare contractors along with troubleshooting and resolving data transmission or content problems.
* Performing analysis based on claim crossover inquiries related to eligibility files and billing.
* Interfacing with and/or lead management and technical application teams and both internal and external business partners to define project specifications, time-lines and deliverables through attendance at client meetings for ongoing and prospective projects.
* Identifying new business opportunities, new systems and processes and possible improvements that can be made to ongoing operations to present to management.
* Identifying, establishing and maintaining business relationships with internal and external trading partners and business partners.
* Training customers and internal employees on the data exchange processes available and the data exchange systems.
* Performing other duties in support of the organization/EDI mission as directed by management.
* Coordinate tasks with our BCRC partners to ensure that all EDI information is correctly formatted to enable us to provide an accurate Response File back to complete the transaction.
* Assist in User Acceptance Testing of system enhancements prior to being moved into production.
* Assist in the development and updating of educational material for the COBSW Site for all EDI Activities.
* Closely work with our external customers to ensure they have a smooth transition from testing to production.
* Respond to inquiries from CMS Central Office and CMS Regional Office staff.

Education

Bachelor's Degree in Computer Science or related field.

Qualifications

Required

* Minimum of 3+ years experience in EDI Activities or related Health Insurance Coordination of Benefits activities
* Knowledge of IBM mainframe, utilities and JCL, TSO, and CICS
* Knowledge of health insurance concepts such as Medicare Part A, B, C and D
* Proven understanding of health insurance concepts and/or experience in HIPAA EDI 837 Professional and Institutional files structures and guidelines
* Designated office space in order to work from home

Desired

* Knowledge of data processing systems and hardware particularly personal computers.
* Working knowledge of object oriented programming.
* Excellent verbal and written communication skills
* Knowledge of telecommunication data delivery methods and telecommunication software and concepts such as NDM (Connect: Direct) and), FTP and dedicated connections.
* Experience in the implementation and maintenance of trading partner accounts in a high-volume, high-paced operation using flexibility in terms of managing many accounts with unique requirements.
* Working knowledge of EDI data translator/validator support, i.e., Sterling Gentran/Ingenix Faciledi a plus.
* Ability to communicate effectively with all levels of management and communities.
* Effective verbal and written communication skills.
* Strong demonstrated planning, organizational, problem solving and analytical skills.
* Excellent interpersonal and customer relationship skills with the ability to work in a very fast paced environment;
* Ability to learn new concepts quickly and independently while maintaining effective communications with other team members
* Strong PC skills including working knowledge and proficiency with Microsoft Office products.
* Past experience working remotely in an at-home office