Healthcare EDI 278 Analyst - Remote

Company: UnitedHealth Group
Location: Atlanta
Posted on: May 28, 2023

Job Description:

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) -You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

• Monitor Daily EDI Transaction Processing
• Troubleshoot and Resolve any EDI processing issues -
• Implementation Team Resource for EDI Mapping, Validation and Testing as required
• Prepare and update program documentation, job aides, and other artifacts as requested
• Scheduled and ad hoc auditing of various systems and databases to support prior authorization transactions
• Process review, data analysis and measurement for various programs related to prior authorizations, claims and member eligibility
• Create process and data flow diagrams for the various programs/projects as assigned
• Preparation of reports as needed by management
• Identification and communication of processing issues to management
• Prepares and coordinates presentations, trainings, etc; used as an educational resource
• Implementation of new technologies and processes (includes testing and follow up)
• May involve some interfacing with clients, managed care customers, IT resources and others when needed
• Assignment of special projects as neededYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:
  • 3+ years of experience within the healthcare data environment - eligibility, claims, etc.
  • 3+ years of experience with data mapping and workflow documentation
  • 2+ years of healthcare EDI Transaction Knowledge and expertise -
  • 2+ years of EDI Production Support and Maintenance experience -
  • 2+ years of EDI testing and validation experience -
  • 2+ years of Healthcare IT experience
  • 2+ years of experience using Microsoft Word (creating and editing documents), Microsoft Outlook (email and calendar), Microsoft Excel (pivot tables, formulas (vlookup, xlookup, match, etc..), and Microsoft Visio (process/data flow diagrams) (2 years)Preferred Qualifications:
    • Bachelor's degree in CS or technology discipline -
    • 2+ years of specific EDI X12 ANSI 278 Transaction Expertise
    • 2+ years of EDI transaction mapping experience
    • 2+ years of experience with SQL (manipulating data and queries) - Relational databases like MySQL, MS SQL, DB2
    • Experience working with cloud based solutions and services
    • Knowledgeable about billing practices and process management concepts - this may include knowledge of CPT coding or reimbursement processes, 3rd party provider enrollments, claims submissions, EDI and HIPAA transactions and/or accounts receivables
    • Ability to write clear technical and functional specsSoft Skills:
      • Solid organization skills and attention to detail
      • Excellent communication skills, both verbal and written, with the ability to interact with various levels of resources internally and externallyTelecommuting Requirements:
        • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
        • Ability to keep all company sensitive documents secure (if applicable)
        • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet serviceCareers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm) -OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. -California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. - - -Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and 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. - - -OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. -

Keywords: UnitedHealth Group, Atlanta , Healthcare EDI 278 Analyst - Remote, Healthcare , Atlanta, Georgia