Technical Analyst

Responsibilities:

• 837 File Mapping:
  •  
    • Analyze and map healthcare data to the correct 837 segments as per CMS guidelines.
    • Align supplemental benefits data with relevant segments to ensure compliance and accuracy.
• Scenario Mapping:
  •  
    • Map CMS supplemental benefit scenarios, ensuring all required data elements are included.
    • Validate and transform data for accurate submission.
• File Format Handling:
  •  
    • Work with X12 837 (healthcare claims transaction) format and JSON to ensure interoperability between systems.
    • Debug and troubleshoot issues in parsing or processing data formats.
• CMS Encounter File Submission:
  •  
    • Assist with the preparation and submission of encounter files to CMS.
    • Ensure compliance with CMS requirements for data reporting and formatting.
• Collaboration:
  •  
    • Work with cross-functional teams, including developers, testers, and stakeholders, to refine mapping requirements.
    • Provide technical documentation and support for implemented mappings.

Skills:
 

• X12 837 File Format Expertise
• JSON File Handling
• Encounter File Submission