Data Exchange Analyst, Medical, Dental & Vision

🕒 May 12

⛰️ Colorado, New York – Remote

⛰️ Colorado – Remote 🗽 New York – Remote

💵 $85k - $100k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

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Capital Rx

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2017

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

Capital Rx is the fastest growing healthtech company in America, dedicated to transforming the prescription pricing and patient care landscape. Founded in 2017, it offers innovative pharmacy benefit management (PBM) services, including customizable pharmacy benefits for large employers and an AI-powered care navigation platform. Capital Rx focuses on delivering cost-effective solutions and operational efficiencies to clients while ensuring transparency and quality care for patients.

📋 Description

• The Data Exchange Analyst is a crucial member of our Data Operations team, responsible for ensuring the accurate, efficient, and secure exchange of healthcare data between Capital Rx – JUDI Health and its various partners, including employers, providers, and other TPAs. • This role focuses on the technical aspects of data integration, file transformation, error resolution, and ongoing monitoring of data feeds for medical, dental, and vision claims. • Develop and implement data validation rules and processes to ensure the accuracy, completeness, and consistency of exchanged data. • Proactively monitor system status and Data Exchange management data to quickly identify potential abnormalities that might impact quality and accuracy. • Analyze data trends to identify potential issues or areas for improvement.

🎯 Requirements

• Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or a related field. Equivalent work experience may be considered • Knowledge of healthcare claim adjudication processes for medical, dental, and vision • Strong knowledge and familiarity with EDI SNIP validations and one of the most widely used tools in the healthcare industry (e.g., EDIFECS) • 2+ years of experience in data analysis, data integration, or EDI (Electronic Data Interchange) specifically within the healthcare industry • Strong understanding of healthcare EDI transactions (e.g., 834 Enrollment, 837 Professional/Institutional/Dental Claims, 835 Remittance Advice) • Excellent analytical, problem-solving, and critical thinking skills • Familiarity with various file transfer protocols (FTP, SFTP, FTPS) • Understanding of HIPAA compliance and other relevant healthcare regulations • Strong attention to detail and a commitment to data accuracy • Ability to analyze complex business problems to discover and resolve root causes • Proficiency in SQL, Excel, JSON and other technical data skills preferred • Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders • Self-motivated and detail-oriented problem solver • Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team.

🏖️ Benefits

• Health insurance • 401(k) matching • Paid time off • Flexible work arrangements • Professional development opportunities