Summary/Objective:

The Operations Quality Assurance Analyst serves as the guardian of data integrity for EDI transactions, specializing in 834 enrollment files. This role combines technical EDI expertise with rigorous quality control measures to ensure accurate client implementations and ongoing data excellence. The analyst implements robust validation protocols while maintaining comprehensive oversight of all data entry and file processing activities.

Required Education and Experience:

• Associate Degree in Healthcare administration or related field
• EDI Experience with 834 files in healthcare environment– 2-5 years
• Preferred Skills – Verification in Quality Assurance or Data Management, knowledge of HIPAA transaction standards, experience with EDI translation software, familiarity with scripting for file automation, client-facing experience in managed file transfer setup

Competencies:

• Strong computer skills, MS Excel in particular (managing spreadsheets, creating charts and using advanced formulas)
• Strong understanding and demonstrated experience in data analysis
• Strong technical skills with expertise in EDI testing methodologies and production migration
• Attention to detail and accuracy
• Ability to take initiatives to meet deadlines for multiple items
• Ability to collaborate with cross functional partners
• Effective written and oral communication

Operations Quality Assurance Analyst Responsibilities:

Quality Assurance and Data Integrity

• Implement multi-layer validation checks for all 834 file data entry and processing
• Establish and enforce quality standards for manual data adjustments
• Conduct regular audits of enrollment records to identify and correct discrepancies
• Develop and maintain data quality scorecards with measurable KPIs
• Document all quality issues and corrective actions in tracking system

EDI Implementation with Quality Controls

• Design and execute comprehensive test plans that validate:
• Data mapping accuracy, Business rule compliance, End-to-end system processing
• Require dual verification for all production migrations
• Maintain version-controlled test scripts and documentation

Production Oversight

• Monitor daily file processing with emphasis on Data completeness, Field-level accuracy, Timeliness of transmissions

Technical Operations

• Work with IT to administer SFTP connections with security and quality protocols
• Configure automated alerts for data quality exceptions
• Maintain data dictionary and eligibility rules documentation

Work Environment:

On-site in Oakland, CA

EEO Statement:

The workplace and decisions made at the employer will be free of disparate treatment based on an employee's race, sex, national origin, color, sexual orientation, religion, disability, age (40 and over) or genetic information.

At Will Statement:

Employment is at will. This means employment is for an indefinite period and it is subject to termination by the employee or the employer, with or without cause, with or without notice, and at any time. Nothing in this job description or any other policy of the employer shall be interpreted to conflict with or to eliminate or modify in any way, the at will employment status of employees.

The at will employment status of an employee may be modified only in a written employment agreement with that employee.

Other Duties:

• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Pay: $22.00 - $27.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Professional development assistance
• Vision insurance

Compensation Package:

• Bonus opportunities

Work Location: In person