- Retrieve inbound/outbound file transactions- EDI, HL7s, and Text files for review.
- Track daily claims processing, PO's, Invoices, Member, provider, Price files, etc. Analyze potential gaps, and coordinate efforts to correct discrepancies.
- Find and escalate both internal and external customer/vendor issues to the proper business partners and drive solutions to resolution.
- Monitor workflow, analyze processes, and make recommendations for improvements.
- Setup and maintain jobs for Inventory, PO's, Price Files, Patients, etc. and support daily changes.
- Coordinate and test implementations with new customers/vendors, and Implementation team.
- Review Exceptions/Bad files and trace issues through the system. Work potential issues with analyst and/or development team to resolution.
- Independently research tickets/issues from start to finish.
- Comfortable working with large raw data files like Csv, Txt, EDI, and Xlsx
- Ability to edit, manipulate, and search information using Excel and Notepad++. Understanding of Pivot tables, VLOOKUP's, filters and calculated fields
- Ability to write SQL queries with an understanding of relational databases, parsing data, and rewriting queries for efficiency
- Ability to recognize past issue patterns/trends and relate them to existing problem resolution processes
- Time management and prioritization allowing for adjustments as priorities change with the ability to complete tasks within deadlines
- Organized with Strong written and Verbal communication skills. Can cohesively present and translate findings to the business/development teams. Comfortable communicating both internally and externally to clients to address issues in a professional manner
- "Can Do" Attitude and willing to "Hit the Ground Running."
- Experience in healthcare industry preferred; 340B industry a plus
- Familiar with Jira and Agile Process
- Experience creating test cases and conducting QA on enhancements/bugs
- Experience working with EMRs, HL7 interfaces/messages (ADT and SIU), EDI, and Patient/Provider information
- Ability to interact on both the business and technical aspects of projects
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Data Monitor - Melville, United States - Nuvem
Description
Job Description
Job DescriptionDescription:The Monitoring position lives in the IT Operations department. The primary responsibilities involve monitoring system status, tracking, investigating, researching concerns and debugging issues.
Responsibilities:
EEO
Required to be IN office 5x a week. Hybrid is not available
Position locations: Melville, NY or Plano, TX
Nuvem Mission
To contribute to healthcare market economical solution driving additional revenue and growth; and to provide high level of customer satisfaction.
Nuvem Vision
To be a dominant healthcare drug-management technology company; to establish holistic software solution in highest standards.
Nuvem Values
Honesty, integrity and fairness in our programs and products; to provide the best values to our customers through continuous development and updated solutions and to honor pour commitments
Requirements:Preferred: