Senior Analyst, Business Analytics
CVS Health
ETLPythonSQL
IT Specialist II, EDI
IEHP
full-time
Posted on:
Origin: • 🇺🇸 United States • California
Visit company websiteSalary
💰 $80,059 - $106,059 per year
Job Level
JuniorMid-Level
Tech Stack
ETLMS SQL ServerSQLSSIS
About the role
- Work with the client implementation team to assist in the onboarding of new clients
- Evaluate X12 transactions (999, 277CA and MAO’s – 837) as well as CSV formats
- Manage file transmissions and continuously strive to improve department processes and procedures
- Responsible for testing during new client implementations and client transitions to other eligibility methods
- Key component in the claim generation process and creation of data to create an X12 837 file for claim submission
- Participate in design and development of client/server systems which utilize pre-defined file formats for all vendors
- Assist with SQL Server-based reporting and database security
- Analyze, design, develop, test, troubleshoot, enhance, and maintain EDI transaction sets including 837, TA1, 999, 277CA, MAO’s and EVR’s and HTML formats
- Maintain detailed documentation and process flow of all EDI processes
- Evaluate client requests for new EDI features and give suggestions to direct manager
- Participate in project meetings providing input to project plans and status updates
- Research questions involving EDI applications and how the data is organized and populated
- Manage and ensure quality and consistent delivery for EDI Encounter transactions (837)
- Ensure correct mapping to response data (837, 999, 277CA and MAO’s)
- Test with Trading Partners for compliance within regulatory and environmental changes related to ANSI transactions
- Use Quality Assurance measures to troubleshoot and resolve issues related to file data loading and processing
- Ensure the privacy and security of PHI as outlined in IEHP's HIPAA policies and procedures
- Perform any other duties as required to ensure successful Health Plan EDI operations
Requirements
- Two (2) years in data extraction, transformation, and loading (ETL)
- One (1) year in database administration and development, using Microsoft SQL Server or similar relational database application
- One (1) year programming with Structured Query Language (SQL)
- Experience preferably in a health care setting
- High School diploma or equivalent
- Bachelor's degree from an accredited institution preferred
- Techniques of relational database analysis, design, and implementation, including data mining and transformation techniques
- MS SQL Server 2012, SSIS, SSRS, SSAS and Data warehousing/data modeling concepts preferred
- Principles and practices of project control, physical and logical security techniques
- Demonstrated strong analytical skills
- Excellent customer service with both internal and external customers
- Excellent verbal and written communication skills
- Ability to read and process ANSI X12 files formats
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
- Ability to meet deadlines and work within a deadline driven department
- Knowledge of HIPAA requirements to ensure privacy and security of PHI
