Client Experience - Sr. Data Analyst (EDI Compliance)
Our goals are to provide excellent service, utilize advanced technology, and proficiently deliver results. To accomplish these goals, we constantly seek individuals who look for ways to do things better. We are a company whose
cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement.
Tabula Rasa HealthCare (TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize performance to improve patient outcomes, reduce hospitalizations, lower healthcare costs, and manage risk. Medication risk management is TRHC’s lead offering, and its cloud-based software applications, including EireneRx® and MedWise™, provide solutions for a range of payers, providers and other healthcare organizations.
TRHC empowers our employees to provide excellent service, utilize advanced technology, and proficiently deliver results. Our 32Fundamentals are what we are and who we are. Our culture cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement. As a part of our team, you will help us bring innovative service models to healthcare, improving patient outcomes.
Tabula Rasa Health Care 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 be 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.Some travel could be required to customer sites and for trainings.
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
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
Education, Experience & Training:
Bachelor’s degree in Computer Science, Bioinformatics or related field
6-8 years as a Data Analyst professional
5+ years’ experience with reporting tools
5+ years’ experience with relational databases (SQL Server, MySQL) to analyze and manage data
Strong SQL skills and experience for programming/implementing projects in existing databases
In depth knowledge of claims management, adjudication and pricing methods, required
Proficiency with compliant HIPAA transaction/code set standards (820,834,835,837,P/I/D), processes and operations development is required
Experience in designing and managing all EDI transactions
Experience with self-service analytics tools and distributed processing a plus
Experience working in a healthcare environment
Extensive knowledge of HealthCare payment cycle and claims forms, financial and accounting concepts, and workflows
Knowledge of Medicare and Medicaid claim rules and regulation, pricing and payment
Familiarity with PACE, MLTC, or other capitated programs a plus
Strong experience with PLEXIS or EZCap a plus
High proficiency with SQL languages (MySQL, SQL Server, DB2)
Excellent client-facing communication skills
Working knowledge in Software Development Life Cycle
Strong knowledge and use of Microsoft Office applications
Strong analytical and problem-solving skills
Overall competency in business and technology
Excited & motivated to learn new technologies
Ability to be flexible with frequent changes
Ability to problem-solve and ability to follow through on tasks
Identify and design solution strategies
Sense of urgency to attend to client demands
Responsive and prompt communication
Excellent time management
Excellent verbal and written communication skills
Self-motivated, team player, highly organized
Attention to detail and accuracy of facts and documentation
Ability to manage multiple priorities and work independently
Expected Hours of Work:This is a full-time position with an expectation to work an average of 40 hours per week, and an ability to be available outside of normal business hours to meet customer expectations on an ad-hoc basis.
Normal business hours are between 8:00 a.m. to 5:00 p.m.
Travel:Some – to customer sites and for trainings
Supervisory Responsibility: None.
Environment:This job operates in a professional, dress for your day, office environment. This role routinely uses standard office equipment such as computers, phones, printers, and filing cabinets.
Physical Demands:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to travel; use hands to finger, handle or feel; and reach with hands and arms.
The Company is proud to be an equal opportunity employer. All qualified applicants will receive consideration without regard to ancestry or national origin, race or color, religion or creed, age, disability, AIDS/HIV, gender, marital or family status, pregnancy, childbirth or related medical conditions, genetic information, military service, protected caregiver obligations, sexual orientation, protected financial status or other classification protected by applicable law.
- Pay Type Salary
- Telecommute % 100