Claims Analyst
5 days ago
Job Location: Remote
Job Type: Contract
Job Description:
The EDI Claims Analyst is responsible for analyzing and processing electronic data interchange (EDI) transactions, including claims and eligibility inquiries. This role involves reviewing and resolving claim rejections, ensuring accurate data submission, and supporting various EDI transactions. The analyst will work closely with provider relations, IT, and other internal teams to ensure smooth and efficient claims processing.
Requirement:
- Strong understanding of EDI transactions and claims processing
- Proficiency in SQL and data analysis
- Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica, and Apigee
- Familiarity with CBH systems, including Connects and Flexicare
- Excellent problem-solving and analytical skills
- Ability to mentor and train team members
- Executive leadership client facing
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