Business Information Consultant

Anticipated End Date:

2025-11-18

Position Title:

Business Information Consultant

Job Description:

Business Information Consultant

Location: Ideal candidates will be able to report to our Pulse Point location at 5800 Northampton Blvd., Norfolk, VA 23502

This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Work Hours:   Monday to Friday, 8:00 am to 5:00 pm

The Business Information Consultant is responsible for developing specifications and requirements for the submission of health care medical encounter data files which meet ANSI X12 data criteria, are HIPAA compliant, and meet state Medicaid and federal Medicare guidelines as expressed in companion guides and technical specifications. These include ANSI X12 transactions 837P, 837I, 837D, 835, 270, 271, 276, 277 and 999 for encounter reporting. Work on Medicaid encounters submission to Ohio, Indiana and NJ state and reconcile the remits received from state.

How you will make an impact:

• Analyze pends, rejects, completeness, accuracy reports and share with stakeholders.

• Gather business requirements to eliminate internal exception as well as external exception codes.

• Work with Encounters IT team to assist with change requests which includes preparing the requirements, testing documentation, completing the mapping, and assisting with system and state testing.

• Produce high quality requirement specifications to support systems functional design development.

• Develop and analyze business performance reports (e.g. for claims data, provider data, utilization data) and provide notations of performance deviations and anomalies.

• Provide analytic consultation to other business areas, leadership, or external customers.

• Analyze data and summarize performance using summary statistical procedures.

• May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

Minimum Requirements:

Bachelor’s degree in Computer Science, or related.

Additional Requirements:

• Five (5) years in any occupation with IT experience.

• Five (5) years in any occupation with IT experience must include: SQL and/or any other similar query language; Defect tracking tool(s); Health care data models; Encounter reporting using the ANSI X12 standards with delegated vendors such as transportation, dental, vision, and chiropractic; End-to-end testing from source data through enterprise applications; Edifecs EM application’s technical and workflow experience; Experience in different X12 transactions and reconciliation of data; and Facets data model and application experience.

Alternate Education/Experience Requirements:

Employer will accept a Master’s degree in Computer Science, or related, and three (3) years in any occupation with IT experience. Must have skills listed above.

SALARY:      $123,261 per year

APPLY:         https://careers.elevancehealth.com/ 

Job Level:

Non-Management Exempt

Workshift:

Job Family:

RDA > Business/Health Info

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and pro