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Prophecy Technologies
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Electronic Data Interchange Business Analyst

Electronic Data Interchange Business Analyst

Prophecy Technologies

8 years

0 Lacs

hyderabad telangana india

Posted:1 week ago| Platform:

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Skills Required

data development healthcare transactions integration support trading resolve mapping authorization flow traceability documentation sql deployment design interface regression pricing management relational server oracle mysql visio agile scrum kanban epic cerner salesforce developer jira power tableau

Work Mode

On-site

Job Type

Full Time

Job Description

Job Title:

Experience:

Work Location:

Work Mode:

Project Type:

Skill Category:

Senior EDI Analyst / Business Systems Analyst

Key Responsibilities

Monitor and support daily EDI transaction flows (837, 835, 278, 834, 270/271) across multiple payer and provider integrations.
Troubleshoot and resolve production issues, including edit errors, rejected files, mapping discrepancies, and reprocessing corrected X12 transactions.
Collaborate with trading partners to validate Authorization (278) and Claims EDI workflows.
Develop functional specifications, source-to-target mappings, data flow diagrams, and traceability documentation.
Create job aids and process documentation for production support and new integrations.
Participate in UAT execution, SQL validation, and post-deployment verification.
Design and support end-to-end trading partner integrations using Cleo Cloud, EDI Fabric, and SQL-based validation.
Lead EDI production support activities including mapping error resolution, reprocessing failed transactions, and partner testing.
Document workflows, ICDs, and interface specifications; collaborate with QA for regression and UAT cycles.
Deliver Medicaid and MMIS solutions through FACETS, covering Claims, Eligibility, NCPDP D.0, and Prior Authorization modules.
Conduct JAD sessions, create BRDs/FRDs, document end-to-end process flows, and perform gap analysis.
Validate backend data using SQL and support UAT and production rollout for claims pricing and member eligibility.

Core Competencies

EDI & HIPAA Transactions:
837, 835, 278, 834, 270/271, SNIP validation
Integration Engines:
Cleo, Sterling, Mirth, Boomi, BizTalk
Claims & UM Systems:
FACETS, MMIS, Utilization Management workflows
EDI Production Support:
Mapping resolution, reprocessing, edits, resubmissions
Data Analysis:
SQL, relational databases (SQL Server, Oracle, MySQL, DB2)
Documentation:
BRD, FRD, ICD, data mapping, Visio workflows, job aids
Agile Delivery:
Scrum, SAFe, Kanban, backlog refinement, user story creation
Healthcare Domain:
Eligibility, provider data, claims adjudication

Technical Skills

EDI Standards:
ANSI X12 (837, 835, 834, 278, 270/271, 810, 850), HL7, NCPDP D.0
Integration Platforms:
Mirth, Boomi, BizTalk, Cleo, IBM Sterling
Healthcare Platforms:
FACETS, Epic, Cerner, Salesforce, Hansen, Edifecs
Databases:
SQL Server, Oracle, MySQL, DB2
Tools:
SQL Developer, JIRA, HP ALM, SoapUI, Visio, Lucidchart
Reporting:
Power BI, Tableau, Crystal Reports
Methodologies:
Agile/Scrum, Kanban, SAFe, Waterfall

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