Incident Management (EDI Claims)

 

 

• Perform end-to-end incident lifecycle management including triage, analysis, resolution, and closure
• Conduct root cause analysis (RCA) and identify recurring incident patterns
• Document incidents, escalations, and resolutions in tracking tools (e.g., ServiceNow, SharePoint, Salesforce)
• Collaborate with development, QA, and infrastructure teams for issue resolution

Data Analysis & EDI Processing
• Analyze and process EDI 837/835 healthcare claims and XML files
• Investigate claim errors (e.g., 999 rejections) and ensure data integrity
• Write and execute complex SQL queries across multi-database (Oracle) environments

Documentation & Continuous Improvement
• Develop and maintain SOPs, runbooks, and system documentation
• Document monitoring design, workflows, and support processes
• Contribute to continuous improvement initiatives and operational efficiency

Required Skills & Qualifications
• Bachelor’s degree in computer science, IT, or related field (or equivalent experience)
• 5–7+ years of experience in IT production support or operations
• Experience with CA-7 job scheduling and batch processing
• Strong analytical, troubleshooting, and problem-solving skills
• Proficiency in SQL and Oracle databases
• Experience with incident management processes and tools
 

• Monitoring Tools: Dynatrace, Jenkins, Prometheus
• Databases: Oracle, SQL, Snowflakes
• EDI: 837/835 transactions, XML processing
• Tools: Jenkins, SharePoint, Salesforce or similar ticketing systems

 

Preferred Qualifications
• Knowledge of Claims Adjudication processes (Healthcare domain)
• Experience with EDI transaction standards and healthcare claims systems
• Exposure to object-oriented programming languages
• Experience working with Blue Cross Blue Shield (BCBS) or similar plans

 

 

 

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