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Position Applying For:IT Lead EDI Specialist

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  • IT Lead EDI Specialist  | USA-NC-Raleigh  |  | 29-JUL-21 
     
    
•           High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
    
•           Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
    
•           Develop and execute test scripts related to X12 Transmission
    
            Conducts QA and Testing on EDI applications
    
            Develop and execute Test scripts related to X12 Transmission
    
            Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing
    
•           Provides technical support during and after implementation for healthcare electronic data interchange applications
    
•           Responds to inquiries regarding EDI issues with encounter claims and trading partner activities
    
•           Management of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
    
•           Communication between Trading Partners and department
    
•           Maintain detailed documentation and process flow of all EDI processes
    
•           Identify and facilitate issues with partner data mapping from onset through completion
    
•           Process and monitor all inbound and outbound X12 transactions
    
•           Support Customer Service group with EDI related issues
    
•           Identifies, recommends and implements process improvements in support of the EDI system
    
•           Troubleshoot EDI document processing errors and work with trading partners directly to resolve in a timely matter
    
•           Conducts analysis of EDI transactions and is responsible for documentation and reports
    
•           Collaborate with EDI partners to resolve transmission problems.
    
•           Track day-to-day EDI & batch processes to identify and address problems as they arise reporting levels of activity using key established metrics for senior management
    
•           Effectively communicate issues and needs with internal business partners, external vendors, and healthcare providers
    
•           Develops and maintains cross walking and validation rules for file exchanges
    
•           Triages incoming EDI issues thru monitoring

    Qualifications

    Expert in developing and executing test scripts related to X12 EDI Transmission
    
Demonstrated proficiency in conducting QA and testing on EDI applications
    
Expert in EDI mapping for 837 OR  277CA OR  834 OR  835 OR  TA1 OR  999 OR  820 OR  NCPDP D.0
    
High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
    
Strong understanding of healthcare claims processing - Claims OR  Provider OR  Eligibility
    
Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing
    
Experience in creating and managing catalog of EDI document types such as 837 OR  277CA OR  834 OR  835 OR  TA1 OR  999 OR  820 OR  NCPDP D.0
    
Working knowledge of Medicaid and/or MMIS
    
Excellent verbal and written communication skills with the ability present to both technical and business audiences.
    
Proven experience in processing and monitoring all inbound and outbound X12 transactions
    
Knowledge of Agile Methodology
    
Experience in collaborating with EDI partners to resolve transmission problems.