Required skills:
Standards Expertise

• Proficiency in standards and best practices for exchanging large data sets from historical, to catch up files and the daily files (process C procedures).
• Familiarity with specific insurance data such as transaction sets like WC, GL, AL, claims and transactional data.

Knowledge of Processes

• Understanding of insurance-specific workflows, such as claims processing, policy management, claims, and billing.
• Awareness of compliance requirements like HIPAA for health insurance transactions, data privacy leading to data anonymization.

Mapping and Transformation Skills

• Ability to create and manage mapping for converting data between formats like XML, JSON, flat files, and EDI.
• Experience with tools like SQL.
• Experience in using both structured and unstructured data.
• Experience with building automated QA process and procedures.
• Experience with master data management concepts and data governance principles
• Familiarity with translation and integration platforms such as Alteryx, or Informatica.
• Knowledge of APIs and their integration into EDI platforms for real-time data exchange.