As a Data Analyst on our TPA Data Operations team, you help monitor and manage data file exchanges with our clients, vendors and internal systems. You understand task workflows and data workflows and communicate effectively with teammates and other departments to quickly resolve issues. You will be part of a team that works to create and maintain data pipelines that are high quality & timely. You have an operationally driven internal cadence with a focus on client satisfaction. Your technical attention is precise, and you also understand how it fits in the bigger picture. You constantly strive to improve your work as well as your team. 

Essential Functions/Responsibilities/Duties 

• Maintain an understanding of the workflows between operational departments 

• Communicate status of ongoing tasks on a regular basis to end users and the Team Lead or DataOps Manager 

• Analyze the mapping of insurance claims, import/export files, and eligibility files for troubleshooting any operational inquiry 

• Identify technical issues that may arise from improper enrollment or enrollment changes on electronic data interchange (EDI) files and coordinate with engineering partners to resolve issues 

• Coordinates ongoing EDI testing, implementations, and upgrades 

• Troubleshoot and report any operational error messages 

• Troubleshoot and report file movement errors including SFTP connections 

• Analyze and compare reports or data files against documented business requirements to ensure quality and identify any gaps 

• Other Duties as assigned the Team Lead or DataOps Manager 

Education and Experience 

• 4+ years of experience with system analysis, data analysis, and/or process improvement 

• 2+ years of experience in the Healthcare Industry 

• An associate or bachelor’s degree is preferred, but not required 

 Required Knowledge, Skills, and Abilities 

• Knowledge of the Healthcare & TPA Industry preferred 

• Excellent critical thinking skills 

• Strong analytical and problem-solving skills 

• Intermediate to Advanced knowledge of Microsoft Office Suite, i.e Excel, Outlook, Word, etc 

• Familiarity with flat file data structures like CSV or pipe-delimited. 

• Experience in using various data analysis tools, such as Excel, SQL, Tableau, Power BI, or other relevant software  

• Demonstrated track record of successfully analyzing data, reviewing requirements, and providing valuable insights and solutions to support business decision-making. 

• Ability to work collaboratively, facilitate discussions, and negotiate requirements among various teams 

• Knowledge/Experience with ANSI 5010 transactions like 837, 835, 834, 270/271 preferred 

Physical Requirements  

• Must be able to remain in a stationary position 50% of the time. 

• The person in this job needs to occasionally move inside the office to access office machinery, filing cabinets, and meeting facilities. 

• Constantly operates a computer and other office productivity machinery, such as copy machine, computer printer, calculator, etc. 

• Frequently positions self to maintain files in file cabinets. 

• Frequently move boxes or equipment weighing up to 25 pounds. 

• Must communicate information and ideas so others understand. Must be able to exchange accurate information in these situations. 

• Must be able to observe details at close range. 

Disclaimer 

This job description is not intended to contain a comprehensive list of activities, duties, or responsibilities, but constitutes a general description of the scope and function of the role within the company. Activities, duties, and responsibilities are subject to change at any time with or without notice.