About The Company
Utah Retirement Systems provides benefits for state and other Utah Public employees through the work of two divisions. The Retirement Office administers pension and retirement benefits. PEHP Health & Benefits specializes in medical, dental, life, and other benefits. We take pride in providing a peace of mind for thousands of Utah families. We are committed to our public mission and maintaining a positive team environment. We offer a competitive salary, and our benefits far exceed what most modern employers offer.
Position Summary
Job Description
Performs a variety of analysis and project management functions related to the Office EDI requirements, including automation of transactions, development of standards, compliance to standards, customer service, and process improvement.
Essential Job Functions And Duties
- Works with department managers, users, and programmers. Identifies and defines data content and business requirements to develop, test, and implement ANSI X12N electronic data interchange technical specifications according to HIPAA & ACA guidelines.
- Performs analysis of X12 and application data files to expedite the testing and implementation of new transactions sets.
- Tests and maintains EDI healthcare and financial transaction sets to include EDI systems programming and mappings; ensuring compliance within current industry standards and regulations.
- Participates in industry standards committees, locally and nationally, tasked with creating, piloting, and implementing national health care recommendations/standards in adherence with new and ongoing federal and state laws, codes, policies, and guidelines.
- Constructs documentation and training materials to communicate technical ideas needed to introduce and explain critical healthcare industry EDI initiatives and evolving HIPAA requirements to management and non-technical company personnel.
- Modifies existing mappings within EDI translator and makes recommendations for changes and modifications to interface files layouts to fine tune EDI transactions.
- Provides technical and operational backup to EDI production staff. Assists EDI Manager in management of trading partner setup and maintenance, troubleshooting and daily production duties.
- Maintains compliance with federal and state guidelines, laws, and rulings for healthcare finance, and other interfacing industries.
- Maintains strict confidentiality.
- Performs other duties as assigned.
Required Experience
Education and Experience
A high school diploma and five (5) years of specific experience in EDI; or an equivalent combination of education and experience.
Knowledge, Skills, And Abilities
This list contains knowledge, skills, and abilities that are typically associated with the job. It is not all-inclusive and may vary from position to position:
Required technical skills include the working knowledge of or ability to:
- EDI concepts including implementation and system design concepts.
- ANSI X12 standards.
- Work with data in various formats.
- Troubleshoot and detect problems.
- Communicate technical concepts in non-technical terms.
- Data communication concepts.
- Work with data interchange file formats such as X12 and XML.
- Methods and standards for project design and control, database fundamentals, data communication (telecommunications) concepts.
Required Mathematical Skills Include Ability To
- Calculate figures and amounts as it relates to daily analysis and verification of EDI files that contain numeric data and aggregate information.
- Apply concepts of basic algebra.
Must Possess Excellent Communication Skills
- Read, analyze, and interpret general business periodicals, professional journals, technical procedures or regulations.
- Draft technical reports and documents needed to analyze a variety of EDI issues or problems.
- Communicate effectively both verbally and in writing.
- Possess excellent interpersonal communication skills, telephone etiquette, and public relations skills.
Must Have The Ability To
- Establish and work effectively in a team environment with professionals, executives, department heads, co-workers and the public.
- Follow written and verbal instructions.
- Prioritize work.
- Perform within deadlines.
- Work well in a team environment as well as independently.
- Multi-task by handling a variety of duties in a timely and efficient manner.
- Follow through with assignments.
- Deal effectively with stress caused by workload and time deadlines.
The incumbent must always demonstrate judgment, high integrity, and personal values consistent with the values of URS.
Work Environment
Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.
Position requires occasional travel for office business. Individual must be physically capable of safely operating a vehicle, possess a valid driver’s license and have an acceptable driving record based upon data provided by a current Department of Motor Vehicle Record (MVR).
