IT Lead EDI Specialist
Raleigh, NC, NC
Contracted
Experienced
Job Title: IT Lead EDI Specialist (HYBRID)
Location: Raleigh, NC
Duration: 12+ Months
Job Description:
The client 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:
Skills:
Location: Raleigh, NC
Duration: 12+ Months
Job Description:
The client 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:
- 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
- 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
Skills:
| Skill | Required / Desired | Amount | of Experience |
| Expert in developing and executing test scripts related to X12 EDI Transmission | Required | 7 | Years |
| Demonstrated proficiency in conducting QA and testing on EDI applications | Required | 5 | Years |
| Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 | Required | 5 | Years |
| High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions. | Required | 5 | Years |
| Strong understanding of healthcare claims processing - Claims, Provider, Eligibility | Highly desired | ||
| Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing | Required | 2 | Years |
| Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 | Required | 3 | Years |
| Working knowledge of Medicaid and/or MMIS | Highly desired | ||
| Excellent verbal and written communication skills with the ability present to both technical and business audiences. | Desired | ||
| Proven experience in processing and monitoring all inbound and outbound X12 transactions | Required | 3 | Years |
| Knowledge of Agile Methodology | Required | 2 | Years |
| Experience in collaborating with EDI partners to resolve transmission problems. | Required | 2 | Years |
| LOCAL candidates only | Required |
Apply for this position
Required*