Company :United Concordia DentalJob Description : 

JOB SUMMARY

This job performs data testing and analysis tasks primarily on data files, but also for portions of system implementation, enhancements, and change requests.  Incumbent may be responsible for one or more of the following:  understanding system functionality, participating in problem solving sessions, identifying process gaps, conducting impact analysis, identifying data problems, analyzing data problems, solving data problems, identifying risks, documenting risks, discussing findings with management team, making recommendations, documenting department procedure documentation, running system reports to extract data, and/or participating in training on specific applications. May provide guidance and mentoring to lower level employees.
 

ESSENTIAL RESPONSIBILITIES

Conduct system testing for data files, communicate results internally and externally, monitor and respond to email database inquiries from clients, analyze enrollment/eligibilty, and process EDI file transmissionsRun system reports, document procedure and risk, solve more complex problems that may arise, identify process gaps, and conduct impact analysis.Create eDelivery directories, conduct internal data review, and create customer profiles.Develop simple system reports to extract and manipulate data. Identify and implement small process improvements.Other duties as assigned.

EDUCATION

Required

High School/GED 

Substitutions

None

Preferred

Bachelor's Degree in Computer and Information Science

EXPERIENCE

Required (one or more of the following)

3 - 5 years in a Business Analyst role3 - 5 years in Data Analytics3 - 5 years in an Electronic Data Interchange (EDI)3 - 5 years in Communications1 - 3 years Enrollment

And

1 - 3 years on Process Improvement

Preferred (one of the following)

1 - 3 years in Reporting1 - 3 years in Data Modeling

LICENSES AND CERTIFICATIONS

Required

None

Preferred

None

SKILLS

Communication SkillsAnalysis of business problems/needsData AnalysisEligibilityEnrollment SystemsMS ExcelProblem Solving & Decision MakingTesting SkillsMS AccessB2B

Language (Other than English)

None 

Travel Required

0%  - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Frequently

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. 

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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