What are the responsibilities and job description for the IN-IDOH Senior EDI Developer position at SnapCode Inc?
Short Description
The IndianaDepartment of Health (IDOH) is seeking an EDI expert in order to maintain and
advance its health insurance claims processing system, ACAPS.
Complete Description
The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers at IDOH, are loaded into our database, are adjudicated based on state and national pricing standards, and as adjudication messages are generated and sent back to the originating provider. This position will work with the project manager, software developers, business analysts, and functional team members on the project activities.
Essential Duties / Responsibilities
"Review update all documentation related to claims processing and EDI transactions
"Identify incompletely documented claims processing and EDI processes, and document them
"Work with development team as a SME as IDOHs ACAPS system is rewritten in .Net
"Act as liaison between OTC team and the Childrens program area on claims processing issues
"Working with technical and functional staff on detailed business requirements, understanding business processes and technology, agency standards, federal and state policies to align with projects goals.
"Write technical specifications based on conceptual design and stated business requirements.
"Test new and existing systems
"Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.
"Provide helpdesk level support for EDI claim transactions.
oProvide support to healthcare providers who interact with IDOHs CSHCS system
oAssist in onboarding new providers
oAssist in onboarding new clearinghouses
"Ability to work independently with less guidance and work with ISDH externals partners as needed.
Skills
SkillRequired / DesiredAmountof ExperienceExpertise RatingMoveBachelors Degree in Computer Science or related fields with IT experienceRequiredDatabase knowledgeRequired5YearsUnderstanding EDI file formats (835, 837, 210)Required5YearsKnowledge of HIPAA regulationsRequiredAbility to solve complex troubleshooting issuesRequiredExcellent verbal and written communication skillsRequiredHealth Industry experienceHighly desiredKnowledge of IBM Websphere (WTX)Highly desiredDatabase/SQL experienceHighly desired
Questions
Question 1
Absences greater than two weeks MUST be approved by CAI management in advance, and contact information must be provided to CAI so that the resource can be reached during his or her absence. The Client has the right to dismiss the resource if he or she does not return to work by the agreed upon date. Do you agree to this requirement?
Question 2
Please provide candidate's email address/
Question 3
Candidate must be local to Indianapolis. Please provide current home address.
Question 4
The candidate pay rate for this position is *** The Provider Markup for this position is 35%. Do you agree to these requirements?
Question 5
Selected resource will be required to work onsite 3 days per week and 2 days remote. Please confirm the resource understands this requirement.
Question 6
Initial technical interview will be via Teams. Final interview will be via Teams or in person, per the request of the manager. Please confirm the resource understands the interview process.
Question 7
Position is expected to extend past 8/15/2026. Please confirm the resource understands this requirement.
Agency Interview Type
Phone and in-person
Work Arrangement
Hybrid
The IndianaDepartment of Health (IDOH) is seeking an EDI expert in order to maintain and
advance its health insurance claims processing system, ACAPS.
Complete Description
The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers at IDOH, are loaded into our database, are adjudicated based on state and national pricing standards, and as adjudication messages are generated and sent back to the originating provider. This position will work with the project manager, software developers, business analysts, and functional team members on the project activities.
Essential Duties / Responsibilities
"Review update all documentation related to claims processing and EDI transactions
"Identify incompletely documented claims processing and EDI processes, and document them
"Work with development team as a SME as IDOHs ACAPS system is rewritten in .Net
"Act as liaison between OTC team and the Childrens program area on claims processing issues
"Working with technical and functional staff on detailed business requirements, understanding business processes and technology, agency standards, federal and state policies to align with projects goals.
"Write technical specifications based on conceptual design and stated business requirements.
"Test new and existing systems
"Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.
"Provide helpdesk level support for EDI claim transactions.
oProvide support to healthcare providers who interact with IDOHs CSHCS system
oAssist in onboarding new providers
oAssist in onboarding new clearinghouses
"Ability to work independently with less guidance and work with ISDH externals partners as needed.
Skills
SkillRequired / DesiredAmountof ExperienceExpertise RatingMoveBachelors Degree in Computer Science or related fields with IT experienceRequiredDatabase knowledgeRequired5YearsUnderstanding EDI file formats (835, 837, 210)Required5YearsKnowledge of HIPAA regulationsRequiredAbility to solve complex troubleshooting issuesRequiredExcellent verbal and written communication skillsRequiredHealth Industry experienceHighly desiredKnowledge of IBM Websphere (WTX)Highly desiredDatabase/SQL experienceHighly desired
Questions
Question 1
Absences greater than two weeks MUST be approved by CAI management in advance, and contact information must be provided to CAI so that the resource can be reached during his or her absence. The Client has the right to dismiss the resource if he or she does not return to work by the agreed upon date. Do you agree to this requirement?
Question 2
Please provide candidate's email address/
Question 3
Candidate must be local to Indianapolis. Please provide current home address.
Question 4
The candidate pay rate for this position is *** The Provider Markup for this position is 35%. Do you agree to these requirements?
Question 5
Selected resource will be required to work onsite 3 days per week and 2 days remote. Please confirm the resource understands this requirement.
Question 6
Initial technical interview will be via Teams. Final interview will be via Teams or in person, per the request of the manager. Please confirm the resource understands the interview process.
Question 7
Position is expected to extend past 8/15/2026. Please confirm the resource understands this requirement.
Agency Interview Type
Phone and in-person
Work Arrangement
Hybrid