EDI Senior Analyst

Transformation is the opportunity

Blue Shield of California is the third largest health plan in California, with about $7.5 billion in revenue. Our mission is to ensure Californian's access to high-quality health care at a reasonable price.

Join Blue Shield of California and grow your career with a leader that's stirring up a change.

Blue Shield of California is a long-established health care firm which is
embarking on a major program to reengineer its core business and to modernize
the technology that supports it. The Shield Advance program will provide the key
technology and business processes which are fundamental to delivering on the
firm's strategies for future growth. Technology opportunities in this program
offer very talented individuals both the stability to be found in an
established, successful organization, and the excitement to be found in a
start-up environment. Provide technical analysis and operational support for
healthcare B2B integration. He or she will be responsible for technical
requirements, testing and documentation of B2B solutions to meet business and
compliance requirements. He or she will act as a liaison for a development team
to the client business users.

Skills:
* Excellent written and verbal communication
* Business and technical requirements development experience
* Healthcare B2B/EDI development and operations experience
* Strong understanding of health plan business cycle and functions
* Strong familiarity with ASC X12 Healthcare Transactions
* Strong familiarity with EDI regulatory requirements (HIPAA)
* Familiarity with Blue Cross/Blue Shield regulatory requirements (Blue
Exchange) a plus
* Experience with Service Level Agreement (SLA) and performance metrics
measurement a plus
* Bachelor's degree and five years experience (or equivalent combination there
of)

Responsibilities:
* Provide Subject Matter Expertise (SME) for EDI real-time transactions
(eligibility inquiry, claim status inquiry and authorization request) for
development and operational support teams.
* Act as liaison between IT and business for work request and requirements
gathering activities.
* Coordinate and maintain transaction documentation (requirements, design, etc... )
* Maintain knowledge of industry trends and regulations to provide input for
transaction development and strategic roadmap

Blue Shield of California is an Equal Opportunity Employer

Our comprehensive benefits begin on your first day with medical, dental and vision coverage; 20 days PTO annually; 9 paid holidays; matching 401(k); and company pension.

Blue Shield of California is an Equal Opportunity Employer.

An Independent Member of the Blue Shield Association.

Blue Shield of California
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