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Sr. Data Analyst - EDI Compliance

Distinctive Staffing Solutions Eden Prairie, MN

  • Posted: over a month ago
  • Full-Time
Job Description

Our Client is looking a Senior Data Analyst to work with clients, business analysts and application developers to help turn disparate data sets into actionable insights. The Senior Data Analyst will be responsible for designing, developing, testing and implementing reports.


This position requires that the analyst have proven experience in claims adjudication applications/systems, data and system analysis, EDI compliance components, data availability and quality, have a strong understanding of the business requirements, and the creativity to develop workable solutions for a wide range of customers.


Primary Functions:

  • Work closely with clients, product owners and other stakeholders to understand their information needs and develop technical solutions; liaison between clearing house and other Healthcare EDI partners
  • Application administrator for Claims Adjudication System
  • Oversee and troubleshoot EDI transaction monitoring and claim related issues
  • EDI 837 files
  • Provide expert support for EDI compliance related issues, including but not limited to claims, clearinghouse data, demographic interfaces and all transaction code standards.
  • Help build and maintain Bi-directional data models to support the infrastructure
  • Write complex SQL and stored procedures for analyzing and reporting datasets
  • Unit test reports to ensure the highest quality deliverable
  • Develop procedures and technical documentation to enhance use of our systems; reporting and query capabilities to improve efficiency and accuracy; document deviations for client set-up
  • Develop innovative approaches to manipulate data sets in a way that enables clients to see patterns and trends
  • Support, troubleshoot and resolve issues, request and inquiries from end users; Monitor compliance with federal and state guideline addressing issues in a timely manner
  • Maintain new code sets and fee schedules
Technical Requirements:

  • 5-8 years as a Data Analyst
  • 4+ years with reporting tools
  • Strong experience with PLEXIS or EZCap a plus. As well as TriZetto, QNXT and Prime Suite
  • EDI experience
  • Medical billing and claims workflow process
  • Understanding of clearing house regulations
  • Strong SQL skills
  • 5+ years’ experience with relational databases (SQL Server, MySQL) to analyze and manage data
  • Strong analytical and problem-solving skills
  • Identify and design solution strategies
  • Client-facing 
  • Customer-service oriented
  • Clearing house regulations

Distinctive Staffing Solutions


Eden Prairie, MN
55344 USA



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