Type of Requisition
Regular
Clearance Level Must Currently Possess:
None
Clearance Level Must Be Able to Obtain:
None
Public Trust/Other Required
None
Job Family:
IT Infrastructure and Operations
Job Qualifications
Skills
Analytical Research, Customer Service, Effective Written Communication, Verbal Communications
Certifications
None
Experience
5 + years of related experience
US Citizenship Required
No
Job Description:
General Dynamics Information Technology (GDIT) is seeking a Systems Analyst Associate to support our client. In this role, you will be administering all aspects of Electronic Data Interchange (EDI) activities including Coordination of Benefits Agreement (COBA) Crossover Process, Section 111, and Data Sharing Agreements with employers. You will also be responsible for troubleshooting and diagnosing issues with direct file transfer and issues experienced with the Coordination of Benefits Secure Website (COBSW). Additionally, you be responsible for the front-line customer service support and education with Stakeholders via the EDI Hotline, requiring strict adherence to call center metrics.
This is a remote opportunity!
Responsibilities
- Monitor the processing of files between mainframe and distributed system including compiling error reports and communicating with the Trading Partners, programmers, Insurers, Employers, Medicare contractors and CMS to resolve
- Interact directly with stakeholders to resolve issues within strict Service Level Agreements (SLAs), including returning all emails, voicemails, and work items within 2 business days.
- Provide front-line support on the EDI Hotline, maintaining strict Schedule Adherence, monitoring AUX code limits, and minimizing missed calls.
- Work independently on assigned business partners with a minimum of supervision
- Troubleshooting and facilitating the resolution of any identified data file transmission and transaction errors including verification that all communication links and interfaces are working correctly and communicating appropriately
- Manage daily workflow queues across multiple systems, including MIRA, BCRS, ECRS, and maintaining internal tracking spreadsheets.
- Working with management to establish, document and maintain EDI procedures by identifying errors and taking corrective action, reconciling EDI transaction through coordination of information with internal and external customers, Accounting Department, IT Department and external vendors to maintain EDI integrity
- Overseeing and maintain the EDI Inquiry Problem database including the evaluation of problems or issues through to resolution by maintaining highly detailed, standardized documentation (who, what, action performed, and outcome) on all interactions.
- Conducting regular audits of EDI transactions to determine accuracy and areas for improvement and maintaining EDI maps and business rules for HIPAA validation software
- Monitoring the daily receipts and processing of claim files from Medicare contractors along with troubleshooting and resolving data transmission or content problems
- Performing analysis based on claim crossover inquiries related to eligibility files and billing.
- Interfacing with and/or lead management and technical application teams and both internal and external business partners to define project specifications, time-lines and deliverables through primary account ownership, including proactively initiating, leading, and facilitating client meetings for ongoing and prospective projects
- Identifying, new business opportunities, new systems and processes and possible improvements that can be made to ongoing operations to present to management
- Identifying, establishing and maintaining business relationships with internal and external trading partners and business partners
- Training customers and internal employees on the data exchange processes available and the data exchange systems
- Performing other duties in support of the organization/EDI mission as directed by management
- Coordinate tasks with our BCRC partners to ensure that all EDI information is correctly formatted to enable us to provide an accurate Response File back to complete the transaction
- Assist in User Acceptance Testing of system enhancements prior to being moved into production
- Assist in the development and updating of educational material for the COBSW Site for all EDI Activities
- Closely work with our external customers to ensure they have a smooth transition from testing to production
- Respond to inquiries from CMS Central Office and CMS Regional Office staff
Education
Bachelor’s Degree or appropriate combination of post-secondary education and relevant work experience.
Qualifications
Required
- Experience as a Customer Support Specialist or similar CS role
- Strong analytical and research skills
- Ability to communicate effectively with all levels of management and communities
- Excellent verbal and written communication skills
- PC skills including working knowledge and proficiency with Microsoft Office products
- Designated office space in order to work from home
Desired
- Technical support experience
- Proficiency in Amazon Web Services (AWS)
- Experience researching and analyzing file layouts, specifically 837 flat files
- Knowledge of health insurance concepts such as Medicare Part A, B, C and D
- Knowledge of health insurance concepts and/or experience in HIPAA EDI 837
- Knowledge of data processing systems and hardware particularly personal computers
- Knowledge of Professional and Institutional files structures and guidelines
- Knowledge of telecommunication data delivery methods and telecommunication software and concepts such as NDM (Connect Direct) and), FTP and dedicated connections
- Experience in the implementation of maintenance of trading partner accounts in a high-volume, high-paced operation using flexibility in terms of managing many accounts with unique requirements
- Working knowledge of EDI data translation/validator support, i.e. Sterling Gentran/Ingenix Faciledi a plus
- Excellent interpersonal and customer relationship skills with the ability to work in a very fast paced environment
- Ability to learn new concepts quickly and independently while maintaining effective communications with other team members
- Past experience working remotely in an at-home office
#GDITFedHealthJobs
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The likely salary range for this position is $55,806 - $74,750. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.
Scheduled Weekly Hours:
40
Travel Required
None
Telecommuting Options
Remote
Work Location:
Any Location / Remote
Additional Work Locations:
Total Rewards at GDIT
Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.
Our Identity Verification Process
As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.
About Our Work
We are GDIT. A global technology and professional services company that delivers technology solutions and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-ready capabilities in AI, cloud, cyber and software development.
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