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EDI Lead Senior EDI Specialist
EDI Lead Senior EDI SpecialistTechNix LLC • Raleigh, West Virginia, USA
EDI Lead Senior EDI Specialist

EDI Lead Senior EDI Specialist

TechNix LLC • Raleigh, West Virginia, USA
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  • [job_card.full_time]
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Job title : IT Lead EDI Specialist

Location : Raleigh NC

Duration : 6 Months

Need local candidates only

Job Description :

NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project.

NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform Project.

This position is responsible for the following activities related to a critical system being developed in-house at the State :

Responsibilities :

  • 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 TANCPDP 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 TANCPDP 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
  • Ability to communicate effectively with technical and business staff
  • Support internal resources to resolve issues answer questions and retransmit EDI documents when necessary
  • Work with end users to ensure user acceptance testing is thorough and complete
  • Employees should be able to work independently with minimal supervision.
  • Knowledge of Agile Methodology

Required Skills :

  • 7 Years Expert in developing and executing test scripts related to X12 EDI Transmission
  • 5 Years Demonstrated proficiency in conducting QA and testing on EDI applications
  • 5 Years Expert in EDI mapping for 837 277CA 834 835 TANCPDP D.0
  • 5 Years High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
  • 2 Years Experience setting up users / new Trading Partner relationship / Standards / Envelope and full cycle testing
  • 3 Years Experience in creating and managing catalog of EDI document types such as 837 277CA 834 835 TANCPDP D.0
  • 3 years Proven experience in processing and monitoring all inbound and outbound X12 transactions
  • 2 Years Knowledge of Agile Methodology
  • 2 Years Experience in collaborating with EDI partners to resolve transmission problems.
  • Highly desired :

  • Strong understanding of healthcare claims processing - Claims Provider Eligibility.
  • Working knowledge of Medicaid and / or MMIS
  • Desired skills :

  • Excellent verbal and written communication skills with the ability present to both technical and business audiences.
  • Key Skills

    SQL,Information Technology,data integrity,Test Scripts,AS2,Access,Excel,ERP,XML,Troubleshoot,Edifact,Computer information system,Sftp,UNIX

    Employment Type : Full Time

    Experience : years

    Vacancy : 1

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    EDI Lead Senior EDI Specialist • Raleigh, West Virginia, USA

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