Elite Technical is seeking a Functional Analyst, with strong EDI 834 file knowledge, to support our customer, a major Healthcare Insurance organization! Our client is in need of an analyst with knowledge in Healthcare Enrollment documentation (834) in order to review and triage the implementation of new EDI file formats from their TPA (and other) vendors.

We are seeking an analytical thinker, someone who can route different enrollment/claims issues to different team members for triage support.

This position is 99% remote (requires to be onsite 1x per QTR in Baltimore MD or Wash DC) and is a contract to permanent opportunity. We are seeking candidates that reside in one of the following states: Wash DC, MD, VA, WV, NC, PA, DE, South NJ.

Required Skills

- This role requires 4 years- experience as a Functional Analyst and a bachelor-s degree. In lieu of a bachelor-s degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
- Experience: 4 years experience as a Functional Analyst
- 4 years experience with EDI 834 file formats.
- Deep, hands-on experience with TriZetto Facets core modules (including Claims, Membership, Billing, and Provider Management) across legacy or Facets G6/6.x platform environments.
- Knowledge of Healthcare enrollment triage/review experience (834 specifically). Background in reviewing 834 forms and triaging any document/file issues for resolution is critical knowledge to have to be successful in this position.
- Must be able to review/manipulate data within an MS Excel spreadsheet. Pivot tables, v-look up
- Analytical skills, exception writing and communication skills
- Must be AGILE! Must be able to work within a fast paced environment.

Preferred:
- Understanding of the LuminX database and architecture to build custom reporting modules, analyze plan costs, or configure diverse benefit plan structures.
- Strong proficiency in using Edifecs tools to map, validate, and troubleshoot HIPAA X12 transactions (e.g., 837, 835, 270/271).
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