Data Analyst

Description

Partnership Health Plan of California (PHPOC) provides insurance to low- income customers in multiple counties throughout California. They work with over 3,000 Healthcare Providers providing healthcare services to their customers.

PHPOC is going live with a new Claims System called HRP and a new File Transfer system called MoveIt. MoveIt will be integrated with PHPOCs Claims System and their Electronic Data Interchange (EDI) system which transfers payments to their Providers for medical services provided to their customers.

This role will initially support Pre Go-Live activities by leveraging their healthcare data experience and SQl skills by getting their 3,000 Providers accounts set-up in MoveIt and then Go-Live activities supporting both MoveIt as well as the Claims System.

Those Go-Live activities will include supporting customers, through both email and phone activities, when payments arent received as expected. Although heavy troubleshooting skills will not be required, the successful candidates will need to investigate why a payment failed to process, using a pre-built script of outlined activities and then escalate the issue to technical support, the Claims Operations Team or another department as needed.

Because the selected candidates will be both getting up to speed and participating in Pre and Post Live Activities, this role will need to be onsite five days each week. After the initial contract period, which goes through March 3, there will be an opportunity to transition to a hybrid two days onsite/week once the platforms have been stablized.

POSITION PURPOSE

The Data Analyst (EDI) is accountable for developing best business practice knowledge and supporting the business in integrating into the Electronic Data Interchange (EDI) solutions (standards and non-standard EDI systems). The Data Analyst (EDI) will also be assisting EDI team in maintaining and running processes/jobs for electronic claims and other EDI transactions which include working with external trading partners, transferring data through secure channels, loading the data to the production environment, and testing files from new providers/trading partners.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Work with providers, clearing houses, 3rd party vendors, and software companies to facilitate exchange of HIPAA-compliant ANSI X12 EDI transactions between PHC and its trading partners.

• Coordinate testing the electronic transactions with trading partners and other certification authorities for projects such as ICD-10 and CORE.Assist EDI team in diagnosing problems with inbound claims, providing assistance to Claims, Member Services, and Provider Relations department staff.

• Work with internal and external implementation teams and work cross-functionally between the business and IT to resolve technical issues.

• Meet with end-users inside and outside of PHC and collect the requirements for developing EDI applications. - Develop SDLC (Software Development Life Cycle) documents such as Business Requirement Document, Process Flow, Business Case Study Document, and Test Case Document.

• Research, analyze, and evaluate technical requirements and specifications for the seamless integration of EDI solutions.

• Analyze and complete EDI requests on time and with high quality including resolving trouble tickets and providing technical solutions.

• Work with programming staff on data formatting/mapping of electronic data and transmission related tasks and issues.

• Develop and maintain the documentation for each interface including policies and procedures related to the highly complex integrated EDI interfaces.

• Assist EDI team in maintaining and running processes/jobs for electronic claims and other EDI transactions using tools such as Active Batch and Oracle TOAD.

• Gain better understanding on the HIPAA-compliant 5010 TR3 specification documents. - Review EDI development work for compliance within the established state and federal guidelines.

• Participate in negotiation of trading partner agreement and provide assistance to providers in preparing HIPAA-compliant transactions for PHC. SECONDARY DUTIES AND

ADDITIONAL RESPONSIBILITIES

• Participate in special projects and assignments as needed.

Skills

Sql, Data, Healthcare Data

Top Skills Details

Sql,Data,Healthcare Data

Additional Skills & Qualifications

Partnership Health Plan of California (PHPOC) provides insurance to low- income customers in multiple counties throughout California. They work with over 3,000 Healthcare Providers providing healthcare services to their customers.

PHPOC is going live with a new Claims System called HRP and a new File Transfer system called MoveIt. MoveIt will be integrated with PHPOCs Claims System and their Electronic Data Interchange (EDI) system which transfers payments to their Providers for medical services provided to their customers.

This role will initially support Pre Go-Live activities by leveraging their healthcare data experience and SQl skills by getting their 3,000 Providers accounts set-up in MoveIt and then Go-Live activities supporting both MoveIt as well as the Claims System.

Those Go-Live activities will include supporting customers, through both email and phone activities, when payments arent received as expected. Although heavy troubleshooting skills will not be required, the successful candidates will need to investigate why a payment failed to process, using a pre-built script of outlined activities and then escalate the issue to technical support, the Claims Operations Team or another department as needed.

Because the selected candidates will be both getting up to speed and participating in Pre and Post Live Activities, this role will need to be onsite five days each week. After the initial contract period, which goes through March 3, there will be an opportunity to transition to a hybrid two days onsite/week once the platforms have been stablized.

POSITION PURPOSE

The Data Analyst (EDI) is accountable for developing best business practice knowledge and supporting the business in integrating into the Electronic Data Interchange (EDI) solutions (standards and non-standard EDI systems). The Data Analyst (EDI) will also be assisting EDI team in maintaining and running processes/jobs for electronic claims and other EDI transactions which in

Experience Level

Entry Level

Job Type & Location

This is a Contract position based out of Fairfield, CA.

Pay and Benefits

The pay range for this position is $36.00 - $36.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)

Job Type & Location

This is a Contract position based out of Fairfield, CA.

Application Deadline

This position is anticipated to close on Nov 20, 2026.

Workplace Type

This is a fully onsite position in Fairfield,CA.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

Were a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.