Wellmark Blue Cross and Blue Shield
EDI Analyst (Open to hiring at Sr. level)
Wellmark Blue Cross and Blue Shield, Des Moines, Iowa, United States, 50319
EDI Analyst (Open to hiring at Sr. level)
Join to apply for the EDI Analyst (Open to hiring at Sr. level) role at Wellmark Blue Cross and Blue Shield.
Company Description Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well‑being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best‑in‑class service, and one that is committed to sustainability and innovation, consider applying today!
Why Wellmark Technology?
Wellmark is building innovative, modern solutions using cutting edge technology. We are driving organizational transformation and business strategy by empowering our technology team to innovate new and elegant solutions to enhance the customer experience. Together, we are leaning into the future, owning the outcome, and driving organizational change to transform how we work.
Job Description Responsible for implementing tactics to achieve Electronic Data Interchange (EDI) strategies by working with multiple business areas and other IT professionals to document requirements, develop, test, and implement electronic transactions with business partners. Support ongoing maintenance of these transactions and troubleshoot and resolve issues that arise. Maintain and support electronic transactions and/or applications by possessing knowledge of the organization’s systems, business processes, as well as current technology advances and IT capabilities. Responsible for building and maintaining relationships with payer and clearinghouses/submitters.
Qualifications
Bachelor’s Degree or direct and applicable work experience
Minimum of 1+ years’ experience in technical business analysis
Experience with electronic eligibility, claim status, billing, pre‑authorizations, claims and payment remittance transactions
Experience with ANSI X.12 compliant EDI transactions, including 820, 270/271, 276/277, 278, 834, 837 & 835s
General knowledge of programming and software development processes
Knowledge of system development life cycle methodologies, including testing coordination
Knowledge and understanding of business dynamics
Knowledge of high level project management methodologies
Strong communication and listening skills
Ability to ask questions to understand others’ issues
Ability to build and maintain relationships based on trust
Ability to see a task through to completion independently and as a team member
Strong analytical problem solving skills; break problems apart systematically to understand the root cause
Ability to organize time and priorities to achieve business results
Ability to make decisions aligned with Wellmark policies, systems, and processes
Job Responsibilities
Ensure EDI implementation projects are analyzed, planned, developed, compliant, tested and completed.
Create test transactions, run tests, find errors and confirm business requirements are met. Capture testing results in a test plan that compares expected to actual results.
Participate in industry workgroups to help define the implementation of ANSI X12 transactions and ensure Wellmark’s compliance with the HIPAA X12 guidelines.
Support and adhere to Wellmark’s software development lifecycle (SDLC), operational and development procedures, and security standards.
Assist other Technology EDI staff in determining best practices for business process improvement to positively impact level of service.
Collaborate with EDI team and Electronic Commerce (EC) Solutions to understand and set direction for EDI transactions.
Manage the day‑to‑day EDI relationships between Wellmark and submitters.
Provide assistance to project managers in project administrative tasks, including project reporting and documentation.
Identify and report deliverable status and/or issues to project manager and leader. Communicate accurately and concisely in a forum appropriate to the audience.
Establish and build working relationships with IT and business teams. Actively listen to others’ ideas; share information and ideas to help team reach goals.
Provide exceptional service for our stakeholders ensuring timely and accurate results.
May organize EDI marketing efforts with submitters.
Other duties as assigned.
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com.
Please inform us if you meet the definition of a "Covered DoD official".
At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but is not limited to: F1‑OPT, F1‑CPT, H‑1B, TN, L‑1, J‑1, etc. For additional information around work authorization needs please refer to the following resources: Nonimmigrant Workers and Green Card for Employment‑Based Immigrants.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Information Technology
Industries Insurance
Referrals increase your chances of interviewing at Wellmark Blue Cross and Blue Shield by 2x.
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Company Description Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well‑being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best‑in‑class service, and one that is committed to sustainability and innovation, consider applying today!
Why Wellmark Technology?
Wellmark is building innovative, modern solutions using cutting edge technology. We are driving organizational transformation and business strategy by empowering our technology team to innovate new and elegant solutions to enhance the customer experience. Together, we are leaning into the future, owning the outcome, and driving organizational change to transform how we work.
Job Description Responsible for implementing tactics to achieve Electronic Data Interchange (EDI) strategies by working with multiple business areas and other IT professionals to document requirements, develop, test, and implement electronic transactions with business partners. Support ongoing maintenance of these transactions and troubleshoot and resolve issues that arise. Maintain and support electronic transactions and/or applications by possessing knowledge of the organization’s systems, business processes, as well as current technology advances and IT capabilities. Responsible for building and maintaining relationships with payer and clearinghouses/submitters.
Qualifications
Bachelor’s Degree or direct and applicable work experience
Minimum of 1+ years’ experience in technical business analysis
Experience with electronic eligibility, claim status, billing, pre‑authorizations, claims and payment remittance transactions
Experience with ANSI X.12 compliant EDI transactions, including 820, 270/271, 276/277, 278, 834, 837 & 835s
General knowledge of programming and software development processes
Knowledge of system development life cycle methodologies, including testing coordination
Knowledge and understanding of business dynamics
Knowledge of high level project management methodologies
Strong communication and listening skills
Ability to ask questions to understand others’ issues
Ability to build and maintain relationships based on trust
Ability to see a task through to completion independently and as a team member
Strong analytical problem solving skills; break problems apart systematically to understand the root cause
Ability to organize time and priorities to achieve business results
Ability to make decisions aligned with Wellmark policies, systems, and processes
Job Responsibilities
Ensure EDI implementation projects are analyzed, planned, developed, compliant, tested and completed.
Create test transactions, run tests, find errors and confirm business requirements are met. Capture testing results in a test plan that compares expected to actual results.
Participate in industry workgroups to help define the implementation of ANSI X12 transactions and ensure Wellmark’s compliance with the HIPAA X12 guidelines.
Support and adhere to Wellmark’s software development lifecycle (SDLC), operational and development procedures, and security standards.
Assist other Technology EDI staff in determining best practices for business process improvement to positively impact level of service.
Collaborate with EDI team and Electronic Commerce (EC) Solutions to understand and set direction for EDI transactions.
Manage the day‑to‑day EDI relationships between Wellmark and submitters.
Provide assistance to project managers in project administrative tasks, including project reporting and documentation.
Identify and report deliverable status and/or issues to project manager and leader. Communicate accurately and concisely in a forum appropriate to the audience.
Establish and build working relationships with IT and business teams. Actively listen to others’ ideas; share information and ideas to help team reach goals.
Provide exceptional service for our stakeholders ensuring timely and accurate results.
May organize EDI marketing efforts with submitters.
Other duties as assigned.
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com.
Please inform us if you meet the definition of a "Covered DoD official".
At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but is not limited to: F1‑OPT, F1‑CPT, H‑1B, TN, L‑1, J‑1, etc. For additional information around work authorization needs please refer to the following resources: Nonimmigrant Workers and Green Card for Employment‑Based Immigrants.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Information Technology
Industries Insurance
Referrals increase your chances of interviewing at Wellmark Blue Cross and Blue Shield by 2x.
#J-18808-Ljbffr