The Data Integration Specialist is part of the MWG-Administrators Division in the Administrative Department. This is an exempt, salaried role that reports directly to the TPA Division Manager. The position is located at 500 Steed Road, Ridgeland, MS. 39157.

GENERAL JOB DUTIES AND RESPONSIBILITIES:

The Data Integration Specialist will play a key role in managing and optimizing the flow of health insurance claims data through clearinghouses, ensuring seamless integration with our claims adjudication system. This position is responsible for setting up, testing, and maintaining accounts with data clearinghouses, ensuring accurate and timely data transmission for claims adjudication. Additionally, the specialist will collaborate in the development of new data crosswalk features and the improvement of the user interface to enhance system functionality. The role also involves performing Electronic Data Interchange (EDI) tasks, including data intake, verification of insurance eligibility, and coordination with third-party payroll systems.

• Clearinghouse Integration & Setup:
• Collaborate with health insurance claims data clearinghouses to establish data accounts.
• Ensure that all data accounts are properly tested, configured, and functional for claims processing.
• Troubleshoot and resolve any issues related to data transmission or account setup.

• Claims Adjudication System Support:
• Monitor and maintain the flow of claims data through the system, ensuring timely and accurate adjudication.
• Work closely with the development team to build and refine data crosswalks for effective data mapping.
• Contribute to the design and improvement of the user interface to enhance usability for claims adjudication.
• EDI Data Intake & Verification:
• Manage EDI processes related to insurance eligibility verification.
• Collaborate with third-party payroll systems to ensure seamless data intake and accuracy.
• Verify and validate incoming data, identifying and resolving discrepancies.
• Development & Testing:
• Assist in the development and testing of new system features, including crosswalk logic and data validation tools.
• Support testing of system updates and new integrations with clearinghouses and third-party systems.
• Collaboration & Communication:
• Coordinate with internal teams, including IT, development, and customer support, to ensure system functionality and issue resolution.
• Communicate with external stakeholders, including clearinghouses, payroll vendors, and insurance providers, to ensure data accuracy and system alignment.

EXPERIENCE AND EDUCATION REQUIREMENTS:

• Bachelor's degree in Healthcare Administration, Data Management, or a related field (or equivalent experience).
• Proven experience working with health insurance claims data, clearinghouses, and EDI processes.
• Familiarity with claims adjudication systems and healthcare billing processes.
• Experience with data integration and testing.
• Strong analytical and problem-solving skills.
• Excellent communication and collaboration skills.
• Ability to manage multiple projects and priorities in a fast-paced environment.
• Experience with healthcare EDI standards such as X12, 837, 835.
• Knowledge of insurance eligibility verification and payroll systems integration.
• Familiarity with SQL or other database query languages.
• Familiarity with user interface design principles for healthcare software.

WORKING ENVIRONMENT:

• Must be able to perform in a very high paced environment and professionally handle interruptions.
• Must have the ability to work under minimal supervision.
• Must be able to prioritize projects, work multiple projects simultaneously, and meet project deadlines.
• Must possess excellent problem-solving skills and have keen attention to details.
• Must demonstrate strong written and verbal communication, interpersonal, and relationship building skills.
• Must be able to handle stressful situations appropriately.
• Must maintain confidentiality and privacy in every aspect of the job.

JOB ESSENTIAL REQUIREMENTS:

The following are job functions that an employee must be capable of performing with or without reasonable accommodation.

• Must be able to read, write, and speak English; Spanish is a plus.
• Must have basic typing skills
• Must be able to work as scheduled.
• Must possess sight and hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of the position as stated above can be fully met.
• Must be able to bend, stretch, reach, and sit or stand at a desk during 85% of the workday.
• Must be able to lift, stoop, and carry small equipment items and supplies, possibly weighing up to 20lbs.

REASONABLE ACCOMODATIONS:

Morgan White Group will reasonably accommodate qualified individuals with a disability so that they can perform the essential functions of a job, unless doing so causes a direct threat to these individuals or others in the workplace and the threat cannot be eliminated by reasonable accommodation or if the accommodation creates an undue hardship to Morgan White Group.

EQUAL OPPORTUNITY EMPLOYER:

MWG is an Equal Opportunity Employer, committed to the principles of the EEOC. All employment decisions are based upon each person's qualifications, abilities, and performance. Our company works to provide an environment where human dignity prevails and all employees and applicants for employment receive equal consideration and fair treatment, without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.