Crescens
Lead EDI Specialist
Crescens, Raleigh, North Carolina, United States, 27601
Job Title :
Lead EDI SpecialistLocation:
Raleigh, NC (Onsite)Duration: 11+monthsType: Contract
Once COVID-19 restrictions are lifted, all work must be completed on site .
Job Description:
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.0Develop 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 testingProvides technical support during and after implementation for healthcare electronic data interchange applicationsResponds to inquiries regarding EDI issues with encounter claims and trading partner activitiesManagement of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0Communication between Trading Partners and departmentMaintain detailed documentation and process flow of all EDI processesIdentify and facilitate issues with partner data mapping from onset through completionProcess and monitor all inbound and outbound X12 transactionsSupport Customer Service group with EDI related issuesIdentifies, 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 matterConducts analysis of EDI transactions and is responsible for documentation and reportsCollaborate 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 managementEffectively communicate issues and needs with internal business partners, external vendors, and healthcare providersDevelops and maintains cross walking and validation rules for file exchangesTriages incoming EDI issues thru monitoringAbility to communicate effectively with technical and business staffSupport internal resources to resolve issues, answer questions, and retransmit EDI documents when necessaryWork with end users to ensure user acceptance testing is thorough and completeEmployees should be able to work independently with minimal supervision.Knowledge of Agile Methodology
Required:
Expert in developing and executing test scripts related to X12 EDI TransmissionDemonstrated proficiency in conducting QA and testing on EDI applicationsExpert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.Strong understanding of healthcare claims processing - Claims, Provider, EligibilityExperience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testingExperience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0Working knowledge of Medicaid and/or MMISExcellent 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 transactionsKnowledge of Agile MethodologyExperience in collaborating with EDI partners to resolve transmission problems.LOCAL candidates only
Lead EDI SpecialistLocation:
Raleigh, NC (Onsite)Duration: 11+monthsType: Contract
Once COVID-19 restrictions are lifted, all work must be completed on site .
Job Description:
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.0Develop 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 testingProvides technical support during and after implementation for healthcare electronic data interchange applicationsResponds to inquiries regarding EDI issues with encounter claims and trading partner activitiesManagement of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0Communication between Trading Partners and departmentMaintain detailed documentation and process flow of all EDI processesIdentify and facilitate issues with partner data mapping from onset through completionProcess and monitor all inbound and outbound X12 transactionsSupport Customer Service group with EDI related issuesIdentifies, 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 matterConducts analysis of EDI transactions and is responsible for documentation and reportsCollaborate 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 managementEffectively communicate issues and needs with internal business partners, external vendors, and healthcare providersDevelops and maintains cross walking and validation rules for file exchangesTriages incoming EDI issues thru monitoringAbility to communicate effectively with technical and business staffSupport internal resources to resolve issues, answer questions, and retransmit EDI documents when necessaryWork with end users to ensure user acceptance testing is thorough and completeEmployees should be able to work independently with minimal supervision.Knowledge of Agile Methodology
Required:
Expert in developing and executing test scripts related to X12 EDI TransmissionDemonstrated proficiency in conducting QA and testing on EDI applicationsExpert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.Strong understanding of healthcare claims processing - Claims, Provider, EligibilityExperience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testingExperience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0Working knowledge of Medicaid and/or MMISExcellent 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 transactionsKnowledge of Agile MethodologyExperience in collaborating with EDI partners to resolve transmission problems.LOCAL candidates only