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Data Quality Specialist - EDI Management

Job ID: 101814 Date posted: March 25, 2020

  • Sharp HealthPlan
  • Finance
  • Business Operations Jobs
  • Day Job
  • Full-Time

Responsibilities

Summary 
The Data Quality Specialist- EDI Management Analyzes and works edits and data quality issues through various tools, edit logs, workbaskets and software applications. Researches data discrepancies identified by data audits and reconciliations and accurately updates the data per manual or electronic processing. Ensures data quality and integrity is maintained, data updates and changes, additions/deletions are managed and completed per service level agreements ,completes data quality reports and audits within established standards and quality and productivity metrics.

If you like the sound of what it means to be a Sharp Health Plan team member, and you meet the qualifications above, please submit your resume along with a brief explanation about why you would be a good fit for this position. We look forward to hearing from you!

Sharp Health Plan is the largest, locally-based commercial health plan in San Diego. We are a not-for-profit organization serving the needs of San Diegans since 1992. As a subsidiary of Sharp HealthCare, San Diego’s largest provider of health care services, we not only serve the people of San Diego, we are the people of San Diego.

Through our unique integration with Sharp HealthCare, we connect our members to an award-winning network of hospitals, medical groups and physicians. We offer health insurance options for individuals, families, groups and businesses that combine affordability, choice, high-quality health care and personal service
Location
This position is located in Kearny Mesa, San Diego County
 
Hours
8-hour Day shift:, weekends and evenings as needed.
 
 
Required Skills and Qualifications
 
  • BA/BS in business, finance, health administration, database management, or information systems required.
  • Minimum one year data management or data quality assurance.
  • Demonstration of accuracy and proficiency with data management concepts, quality assurance, data audit, and data entry skills.

 

Preferred Skills and Qualifications
  • 2 years’ Experience with Managed Care or Claims Processing Software Applications; Facets, QNEXT, Healthedge, GE MCA. 
  • Some experience with electronic data transfers and file downloads, automated data audit processes.
  • Experience working with Health Plan data such as benefit, member, group, employer information
  • Expertise with data manipulation tools and data tables using excel, MS Access, SQL or other software

Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class.

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Sharp HealthPlan
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“After nearly 10 years of working here, it's still one of the hardest jobs I've ever loved. If you find a niche here, you'll be working with some of the smartest in the industry. This is where they'll respect you for thinking outside the box and kindness matters. They expect consistency and hard work, but pay you well to do it.”

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