Capital Rx

Affordable Pharmacy Benefits, Powered by Modern Infrastructure.

Data Exchange Analyst

AnalystAnalystFull TimeRemoteTeam 501-1,000Since 2017H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

40 days ago

Salary

$85K - $110K / year

Bachelor Degree1 yr expEnglishSQL

Job Description

• Attend new client implementation meetings with external partners to discuss eligibility requirements and protocols • Recommend eligibility file formats to external partners and coordinate receipt and processing of eligibility data • Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols • Serving as a point of coordination for member eligibility issue identification and issue resolution with internal teams and external partners • Identify and triage eligibility issues and support the resolution of all errors related to transferring, loading, and management of eligibility data • Proactively monitoring system status and eligibility data to quickly identify potential abnormalities that might impact quality and accuracy • Ensuring that all issues and errors are resolved using designated operating standards and within defined service levels • Assist with the validation of eligibility data integrity through regular audits and reconciliation processes • Ensure accurate and timely entry of group/plan structure determinations for benefits and enrollment

Job Requirements

  • Bachelor’s degree
  • 1+ years of previous work experience, preferably in PBM, Healthcare, Data Exchange, and Eligibility
  • Ability to match key PBM concepts and data fields across various systems and file layouts to ensure consistency and accuracy of data transfers
  • Ability to analyze complex business problems to discover and resolve root causes
  • Proficiency in SQL, Excel, JSON and other technical data skills preferred
  • Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders
  • Self-motivated and detail-oriented problem solver
  • Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team

Related Categories

Related Job Pages

More Analyst Jobs

Senior Epic Radiant Analyst

Margie and Bill Klesse College of Engineering and Integrated Design at UTSA

Identifying and solving grand challenges where humanity intersects with the physical world.

Analyst40 days ago
Full TimeRemoteTeam 51-200H1B No Sponsor

Senior Epic Radiant Analyst supporting clinical information systems in a remote role

Texas

IT Tech Support – Tier 1 Analyst

Effortless Office

Migrate your business to the cloud with custom enterprise-grade solutions that save you money and revolutionize your ops

Analyst41 days ago
Full TimeRemoteTeam 51-200Since 2010H1B No Sponsor

IT Tech Support - Tier 1 Analyst providing troubleshooting support for clients

AzureVMware
United States
$18 - $20 / hour

Senior ATM Technical Services Analyst

EEOC

Advancing EEO for all. Sharing information here to help you understand and prevent employment discrimination.

Analyst42 days ago
Full TimeRemoteTeam 1,001-5,000Since 1965H1B No Sponsor

Senior Analyst monitoring ATM network and providing technical assistance

ITSM
Pennsylvania
$24 - $40 / hour
Full TimeRemoteTeam 10,001+Since 1856H1B Sponsor

Open this job to view full details and requirements.

United States
$6.2K - $30.1K / year