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Data Quality Specialist - EDI Management

Send to my Email Email a friend Job ID 75173 Date posted 08/02/2016
Requisition ID: 75173
  • Facility: Sharp HealthPlan
  • City: San Diego
  • Department: Finance
  • Category: Business Operations Jobs
  • Job Status: Full-Time
  • Shift: Day Job
  • FTE: 1.0
  • Shift Start: Variable
  • Shift End Time: Variable
Location
This position is located in Kearny Mesa, San Diego County
 
Hours
8-hour Day shift:, weekends 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.
  • Expertise with data manipulation tools and data tables using excel, MS Access, SQL or other software.
  • 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

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.
Sharp Health Plan offers a variety of coverage options that combine affordability and choice, while delivering high quality health care and personal service. We provide health insurance for companies of all sizes throughout the region. Members have access to valuable plan enhancements, such as interactive wellness resources, dental discounts and our exclusive global emergency services program.
Sharp Health Plan is San Diego’s only locally based commercial health plan. With a personal approach and a superior network of medical groups and physicians, Sharp Health Plan advocates for its members by providing unparalleled quality and access to health care services. It operates as a not-for-profit health plan, committed to delivering the best health care for the best value.
As one of the top-rated health plans in California (as measured by the CAHPS satisfaction survey), Sharp Health Plan serves a growing number of companies, large and small, in San Diego and southern Riverside counties.
Additional physical requirements of position may be discussed during interview.
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.
Keywords:  Health Plan data management, finance, EDI processing, EDI transaction
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