RFR #150_MD78SrSystemsAnalystEDIRFR020326

The Maryland Health Benefit Exchange is seeking up to two Senior Systems Analysts to provide Electronic Data Interchange (EDI) data analysis, transaction and support services, and other related services. The ideal candidate will have a minimum of four years of experience with the Health Exchange marketplace EDI solutions, creating EDI X12 files, and analyzing, testing, and providing data solutions for healthcare marketplaces. The candidate will be responsible for performing data analysis, transactional support, error detection, resolution, and all related services for the successful Electronic Data Interchange (EDI) Operations of the Exchange. • Provide data analysis, transactional support, error detection, resolution, and all related services for the successful Electronic Data Interchange (EDI) Operations of the Exchange. • Perform 8001 Medicaid transaction file analysis and validations. • Review and resolve all data issues, including but not limited to Master Data Management (MDM), Master Person Identifier (MPI), and other data issues. • Perform HBX System Error analysis. • Validate 1095-A and 1095-B files, and reconcile 8001 transactions. • Analyze EDI files sent to and received from Carriers, Managed Care Organizations (MCO), and other entities, and identify errors and root causes for EDI file rejections. • Coordinate with the development team, business team, and testing team to analyze, fix, test, and transmit EDI files daily and as required. • Analyze the EDI 999 files from the Carriers and MCOs and perform root cause analysis for exceptions, and assist with resolving any data issues. • Perform data changes to fix consumer or system-reported errors, coordinate with technical and business teams to analyze error reports, access the HBX databases and applications to perform root cause analysis for transaction rejections, and provide data fixes and technical solutions. • Communicate with the IT team, business team, vendor teams, and other stakeholders to translate business needs into EDI data fixes and solutions.