EDI Senior Business Analyst/ Enrollment File Processing at Appirio


The Sr. Business Analyst role is one of both an individual contributor and a deputy manager responsible for assisting Business Analysts and coordinating their efforts in tandem with Sr. Leadership. This role is vital to the organizational goal of ensuring a seamless Enrollment experience for clients and members. This role requires extensive knowledge of EDI / Enrollment File Processing, 834 File Reading & Formatting, FFM/SBM Enrollment File Processing Requirements, and the ability to perform data analysis in these fields. This role includes several crucial responsibilities: creating and maintaining documentation of business processes, relevant process control points, internal and external reporting, and gap/needs analysis from an end-to-end perspective. Additionally, this role functions as a liaison between Operations, IT, Regulatory/Government Affairs, Clients, and Regulatory Partners/Governing Agencies (Federal and State Based Exchanges, Centers for Medicare and Medicaid Services, etc./). The ultimate objective of this role is to ensure seamless and sound business processes along with any necessary control processes are in place, are documented, and adhere/comply with all exchange/regulatory requirements in the Enrollment File Processing space. The Analyst will participate in meetings with Operations, IT, Business Partners/Clients, and any applicable Regulatory body to facilitate the understanding, clarification, and implementation of business performance, processes, and controls.
  • Understands business process management and business requirements of the customers and translating them to specific process, control, and reporting requirements
  • Very strong technical skills, coupled with business intelligence and a deep understanding of the customer's needs so that they can be transformed into application and operational requirements
  • Strong data analysis skills – the ability to create business intelligence
  • Writing descriptions of business needs and business program functions, including creating process and data flow diagrams, workflow diagrams, test scripts, training curriculum, and quality assurance/audit procedures.
  • Drafting raw curriculum to support development of training materials relevant to the approved client business processes.
  • Establishing and maintaining positive client business relationships across the organization, including guiding others in understanding client businesses, processes, and priorities.
  • Subject Matter Expertise with EDI, Enrollment File Processing, 834 Files
  • Other tasks as outlined by management
  • >2years’ work experience that reflects a proven track record of proficiency in the operational competencies noted.
  • The ideal candidate is a self-motivated leader knowledgeable in all aspects of Enrollment (EDI / 834) File Processing as it relates to the Federal and State Based Exchanges
  • Demonstrate strong organizational skills ensuring effective cross-team collaboration.
  • Strong data analysis background is required

Remember to mention that you found this position on MyCareer