What are the responsibilities and job description for the IT Lead EDI Specialist/Tester (Medicaid/Healthcare) - HYBRID position at Chandra Technologies, Inc.?
Job Description:
***Crop to Crop resumes are accepted
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 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
Required Skills:
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, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 |
High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions. |
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, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 |
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. |
LOCAL candidates only |
Desired Skills:
Strong understanding of healthcare claims processing - Claims, Provider, Eligibility |
Working knowledge of Medicaid and/or MMIS |
Excellent verbal and written communication skills with the ability present to both technical and business audiences. |