IT Lead EDI Specialist

4 weeks ago

Raleigh, United States DataStaff, Inc. Full time

DataStaff, Inc. is currently seeking an IT Lead EDI Specialist for a long-term contract opportunity with one of our direct clients in Raleigh, NC.


*This position is hybrid


Responsibilities:

  • 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
  • Provide technical support during and after implementation for healthcare electronic data interchange applications.
  • Respond to inquiries regarding EDI issues with encounter claims and trading partner activities.
  • Manage catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0.
  • Communicate 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.
  • Identify, recommend and implement 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.
  • Conduct analysis of EDI transactions and be responsible for documentation and reports.
  • Collaborate with EDI partners to resolve transmission problems.
  • Track day-to-day EDI and 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.
  • Develop and maintain cross-walking and validation rules for file exchanges.
  • Triage 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:

  • 7 years: Expert in developing and executing test scripts related to X12 EDI Transmission
  • 5 years: Demonstrated proficiency in conducting QA and testing on EDI applications
  • 5 years: Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
  • 5 years: High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions
  • 2 years: Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing
  • 3 years: Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
  • 3 years: Proven experience in processing and monitoring all inbound and outbound X12 transactions
  • 2 years: Knowledge of Agile Methodology
  • 2 years: Experience in collaborating with EDI partners to resolve transmission problems.


Highly 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



This position is available on a corp-to-corp basis or as a W2 position with a competitive benefits package. DataStaff, Inc. offers medical, dental and vision coverage options as well as paid vacation, sick and holiday leave. As many of our opportunities are long-term, we also have a 401k program available for employees after 6 months.

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