saferidehealth
Senior EDI Business Analyst
United States · Senior
Sponsorship not specifiedDetected 13 hours ago
SQLData EngineeringData VisualizationComplianceAccount ManagementExcelHIPAACommunicationProblem SolvingClaims Management
About the role
- EDI Business Analyst to ensure the accuracy and completeness of healthcare encounter data submissions to CMS (Centers for Medicare & Medicaid Services).
- This role serves as the key liaison between business, technical, operations, and compliance teams, ensuring our encounter data management processes meet regulatory and client standards.
- This is an opportunity to contribute to healthcare innovation while driving operational excellence and data integrity at scale.
Responsibilities
- Own end-to-end encounter data management processes to ensure compliance with CMS and state Medicaid guidelines.
- Compile, analyze, and validate encounter submissions to ensure accuracy, completeness, and alignment with Service Level Agreements (SLAs).
- Support audit and regulatory reporting initiatives by developing and maintaining documentation and validation frameworks.
- Develop and maintain processes to extract and transform data from source systems into HIPAA X12 837P format for encounter submissions.
- Collaborate cross-functionally with account management, data, and operations teams to gather requirements, document workflows, and oversee vendor or client deliverables.
- Analyze data to identify trends, anomalies, and root causes, providing actionable insights to optimize workflows and improve ETL efficiency.
- Recommend and implement process improvements that enhance scalability, accuracy, and compliance across encounter data workflows.
Requirements
- Hands-on experience with HIPAA X12 837P Medicaid submissions, including loop and segment structures, and regulatory reporting to CMS or state agencies.
Nice to have
- Strong SQL and Excel skills, with familiarity in data visualization tools such as Tableau, Looker, or QuickSight.
- Experience with Edifecs or similar EDI tools.
Skills
- Strong analytical, problem-solving, and communication skills.
Compensation
- Competitive salary and annual bonus opportunities
Benefits
- Competitive salary and annual bonus opportunities
- Comprehensive health, dental, and vision insurance
- Generous PTO, 10 paid company holidays, and paid parental leave
- About SafeRide Health
- SafeRide Health is a technology and services company committed to eliminating transportation barriers to healthcare.
- By combining our proprietary tech platform with a nationwide network of vetted transportation providers, we empower payers and health systems to deliver smarter, more reliable non-emergency medical transportation.
- Our platform supports the nation's largest Medicare Advantage, Medicaid, and provider programs-improving health outcomes and patient experiences at scale.
- SafeRide Health is seeking a Sr.
- Remote with flexible hours
Company info
- You'll play a pivotal role in analyzing, validating, and optimizing data pipelines that support our mission of removing barriers to care for underserved populations.
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