Technical Specialist

Job Details Provides EMC testing and/or help desk support for medical, dental and hospital providers, along with vendors and other EmblemHealth departments. Prepares EMC reports on a daily basis.• Provides testing and/or help desk support for medical, dental and hospital providers, along with practice management system vendors and billing services • Coordinates with IT and other departments to resolve EMC related issues. • Coordinates and supports Claims Operations with EDI transmission issues. • Participates in telemarketing initiatives to providers, vendors, billing services to promote electronic programs, along with resolving testing issues. • Manages and coordinates EDI PHI issues with other departments• Manages issues relating to HIPAA including: Recording/registering providers and vendors in EDI Gateway program manager for the receipt and distribution of HIPAA transactions • Monitors the execution of EMC medical, dental and hospital systems, produces and distributes EMC reports, performs bi-weekly lab recon process, and monitors OCR processing • Logs, schedules, processes EDI transactions in support of commercial provider claims, laboratories and Medicare Part B and Part A crossover carriers • Ability to Work Independently, Proven Record for Meeting Goals and Objectives• Superior Analytical Ability and Competent Product Knowledge of All Business Lines• Decision Making Skills and Ability to Problem Solve / Keep Superiors Apprised of Potential Issues• Effective Organizational Skills and Ability to Work Under Pressure• Sharp Documentation Skills for Departmental Procedures to Support SOX Initiatives• Positive Professional Attitude, Effective Communication Skills• College, technical training or equivalent working experience• 5 years of experience in claims processing systems and Membership and Provider Files • 3 years of EMC experience in a healthcare support environment