EDI Analyst I

This position is open to a level I or level II EDI Analyst; the requirements for each level is listed below

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

This position for use in Health Plans Departments only. Under the supervision of the EDI Analyst Senior, this position will provides technical support during and after the implementation of the health care Electronic Data Interchange (EDI) setups. Responds to inquiries regarding EDI issues with enrollment, claims, payments and/or clearinghouse activities. This position is not responsible for providing care to patients.

Corporate Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

Responsibilities

• Performs EDI setups of clearinghouse information and ACH payments to customers following specified procedures.
• Maintains procedures as needed with appropriate updates.
• Performs setups of data exchanges between entities for health plans..
• Validates data locations from customer data feeds.
• Maps data feeds into Health Plan formats.
• Where appropriate, loads, monitors and tests incoming and outgoing EDI transactions in a timely manner.
• Ensures the accuracy of data, analyzes conflicting data, works with partner entities to verify and resolve data errors.
• Communicate in a professional manner (verbal and written) with customers and team members when there are problems or changes required.
• Provides documents to providers and outside agencies as required.
• Assist with projects as required.

• Ability to use office desktop tools effectively (e.g. word processing, email, presentation software and spreadsheets).
• Demonstrated ability to utilize spreadsheets to find trends or problems with data sets.
• Knowledge of health insurance industry data and standards.
• Knowledge of processes and procedures of various health plan claim flows from intake to provider payment.
• Demonstrated customer relations and effective communication skills.
• Ability to work well alone or in a team setting.
• Ability to perform the essential functions as outlined above., * Associate’s degree, or equivalent experience in an IT setting.
• Proficient in Microsoft business applications.
• Experience in collecting, organizing, analyzing, and presenting data.

Required for Level 2

• Associate’s degree, or equivalent experience in an IT setting.
• One year of experience with Health Plan EDI processes .
• Proficient in Microsoft business applications.
• Experience in collecting, organizing, analyzing, and presenting data.
• Solid understanding of EDI ANSI X12 transactions.

Qualifications (Preferred)

Preferred

• Experience with Epic Tapestry claims processing system.
• Demonstrated attention to detail and process flows

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions., University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.