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Data Exchange Analyst, Medical, Dental & Vision
Location
Colorado + 1 moreAll locations: Colorado | New York
Posted
13 days ago
Salary
$85K - $100K / year
Seniority
Mid Level
Job Description
Data Exchange Analyst, Medical, Dental & Vision
Capital Rx
• The Data Exchange Analyst is a crucial member of our Data Operations team, responsible for ensuring the accurate, efficient, and secure exchange of healthcare data between Capital Rx – JUDI Health and its various partners, including employers, providers, and other TPAs. • This role focuses on the technical aspects of data integration, file transformation, error resolution, and ongoing monitoring of data feeds for medical, dental, and vision claims. • Develop and implement data validation rules and processes to ensure the accuracy, completeness, and consistency of exchanged data. • Proactively monitor system status and Data Exchange management data to quickly identify potential abnormalities that might impact quality and accuracy. • Analyze data trends to identify potential issues or areas for improvement.
Job Requirements
- Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or a related field. Equivalent work experience may be considered
- Knowledge of healthcare claim adjudication processes for medical, dental, and vision
- Strong knowledge and familiarity with EDI SNIP validations and one of the most widely used tools in the healthcare industry (e.g., EDIFECS)
- 2+ years of experience in data analysis, data integration, or EDI (Electronic Data Interchange) specifically within the healthcare industry
- Strong understanding of healthcare EDI transactions (e.g., 834 Enrollment, 837 Professional/Institutional/Dental Claims, 835 Remittance Advice)
- Excellent analytical, problem-solving, and critical thinking skills
- Familiarity with various file transfer protocols (FTP, SFTP, FTPS)
- Understanding of HIPAA compliance and other relevant healthcare regulations
- Strong attention to detail and a commitment to data accuracy
- Ability to analyze complex business problems to discover and resolve root causes
- Proficiency in SQL, Excel, JSON and other technical data skills preferred
- Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders
- Self-motivated and detail-oriented problem solver
- Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team.
Benefits
- Health insurance
- 401(k) matching
- Paid time off
- Flexible work arrangements
- Professional development opportunities
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