Principal Information Systems Analyst - Lead EDI Developer (N387)

Salary Range: $47.94-$69.18 per hour

SUMMARY

The Los Angeles County Department of Homeless Services and Housing (HSH) consolidates our countywide response to homelessness. The driving force behind HSH is increasing accountability and transparency, improving care for people experiencing or at risk of homelessness, and streamlining collaboration with partners including services providers, the County’s 88 cities, and unincorporated areas to deliver high-quality, life-saving care.  Staff schedules are based on business need and may include the option of a hybrid work schedule where employees work remotely and from the office.

The Principal Information Systems Analyst (Lead Analytics Engineer, EDI Claims Integration) serves as the HSH technical lead for transforming data on homelessness services into Medicaid claims and managing the end-to-end Electronic Data Interchange (EDI) workflow for claims billing. This role owns the production claims data pipeline, ensuring accurate, compliant submission of claims, timely ingestion of acknowledgements and remittance files, and rapid diagnosis of data quality, pipeline contaminations, and denial issues as services move through the claiming lifecycle.

The position combines hands-on technical oversight with technical operational leadership, working closely with program partners, clearinghouses, finance, and internal data engineering staff to maintain a reliable, auditable, and evolving claims process for non-traditional Medicaid services including but not limited to the provision of housing navigation services, recuperative care services.

ESSENTIAL FUNCTIONS

• Operate, maintain the (existing) production pipeline that transforms homelessness service data into ANSI X12 837P transactions using Python-based workflows and clearinghouse translation tools.
• Work with Data Engineering team to enhance or extend existing Python-based workflows as claiming requirements or program needs change.
• Integrate eligibility and enrollment data, including bulk eligibility checks, into the charge capture and claim construction data pipelines
• Submit claims through healthcare clearinghouses and monitor end-to-end transaction flow
• Programmatically ingest, track, and manage EDI acknowledgements and remittances, including ANSI X12 999, 277, and 835 transactions, maintaining clear lineage from service records through payment outcomes
• Identify, flag, and diagnose data quality issues, claim drop-off points, and denial patterns; coordinate and generate claim corrections and resubmissions
• Ensure compliance with HIPAA transaction standards and applicable Medicaid claiming rules throughout the claims lifecycle
• Lead technical discussions with program partners to refine service definitions, documentation standards, and claims workflows as program requirements evolve
• Provide technical direction and guidance to staff responsible for interpreting claims processing performance reports and performing remittance analysis and billing-related data quality root cause analysis.
• Collaborate with finance, analytics, and data engineering teams to support reconciliation, reporting, and continuous improvement of claims performance
• Maintain clear technical and process documentation for claims workflows, controls, and system dependencies.
• Support testing, validation, and onboarding of new service types or program configurations.
• Identify opportunities to develop analytics solutions for process automation, monitoring, and quality assurance improvements across the claims pipeline; and serve as a subject matter expert while working collaboratively with other data engineers, analysts, and scientists.
• Participate in cross-departmental initiatives related to Medicaid data, reporting, or system modernization.

JOB QUALIFICATIONS

Graduation from an accredited college with a bachelor's degree in Computer Science, Information Systems, or a closely related field, and four (4) years of progressively more responsible, full-time, paid experience in a centralized Information Technology organization performing information systems analysis and design for complex systems. -OR- Two (2) years of experience, within the last three years at the level of the Los Angeles County class of Senior Information Systems Analyst -OR - Five (5) years of progressively responsible, full-time, paid experience in a centralized Information Technology organization performing information systems analysis and design for complex systems.

Certificates/Licenses/Clearances

• A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions.

• Successful clearance of the Live Scan process with the County of Los Angeles.

Other Skills, Knowledge, and Abilities

• Experience using code-based data pipelines (Python, SQL, Scala, R, etc.) and modern cloud-based data platforms to cleanse and transform data
• Experience collaborating with others and version controlling (e.g. GitHub) code-based pipelines
• Experience working with healthcare claims data and Electronic Data Interchange (EDI) in a production environment
• Demonstrated experience with ANSI X12 transaction sets, including 837, 835, 999, and 277
• Working knowledge of HIPAA transaction standards and Medicaid claiming rules
• Experience operating or supporting claims workflows involving non-traditional or non-clinical services, such as community-based, housing, or social support programs, is strongly preferred
• Proven ability to diagnose complex data and process failures, explain root causes to non-technical partners, and drive corrective action
• Experience providing technical guidance and consultation to business operations colleagues in managing and overseeing the operational performance of the claims billing processes through active participation in a complex, cross-functional workgroups

PHYSICAL DEMANDS

Stand: Frequently

Walk: Frequently

Sit: Frequently

Reach Outward: Occasionally

Reach Above Shoulder: Occasionally

Climb, Crawl, Kneel, Bend: Occasionally

Lift / Carry: Occasionally - Up to 15 lbs

Push/Pull: Occasionally - Up to 15 lbs

See: Constantly

Taste/ Smell: Not Applicable

 

Not Applicable = Not required for essential functions

Occasionally = (0 - 2 hrs/day)

Frequently = (2 - 5 hrs/day)

Constantly = (5+ hrs/day)

WORK ENVIRONMENT

General Office Setting, Indoors Temperature Controlled

EEOC STATEMENT

It is the policy of Heluna Health to provide equal employment opportunities to all employees and applicants, without regard to age (40 and over), national origin or ancestry, race, color, religion, sex, gender, sexual orientation, pregnancy or perceived pregnancy, reproductive health decision making, physical or mental disability, medical condition (including cancer or a record or history of cancer), AIDS or HIV, genetic information or characteristics, veteran status or military service.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

See job description