Lead EDI Systems Specialist
2 weeks ago
Location: Raleigh, NC
Duration: 12+ months
Type: Contract
****** LOCAL candidates only******
**** Once COVID-19 restrictions are lifted, all work must be completed on site****
Overview:
Client is in search of a proficient Lead EDI Specialist / Tester to contribute to the Managed Care Transition Project.
Key Responsibilities:
- Support the Medicaid Reform Project by leveraging extensive knowledge in EDI processes.
- Oversee critical system development with a focus on in-house initiatives.
- Utilize comprehensive understanding of HIPAA X12 EDI Transactions.
- Demonstrate expertise in EDI mapping for various transaction types including 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0.
- Develop and execute testing scripts related to X12 transmissions.
- Conduct quality assurance and testing on EDI applications.
- Facilitate user setup and establish new Trading Partner relationships, including standards and envelope testing.
- Provide ongoing technical support for healthcare electronic data interchange applications.
- Address inquiries related to EDI issues, encounter claims, and trading partner activities.
- Manage a catalog of EDI document types.
- Ensure effective communication between Trading Partners and the department.
- Maintain comprehensive documentation and process flows for all EDI operations.
- Identify and resolve issues related to partner data mapping throughout the project lifecycle.
- Monitor all inbound and outbound X12 transactions.
- Assist the Customer Service team with EDI-related inquiries.
- Recommend and implement process enhancements to optimize the EDI system.
- Troubleshoot EDI document processing errors, collaborating with trading partners for timely resolutions.
- Analyze EDI transactions, ensuring proper documentation and reporting.
- Work closely with EDI partners to address transmission challenges.
- Track daily EDI and batch processes, identifying and resolving issues as they arise.
- Communicate effectively with internal business partners, external vendors, and healthcare providers.
- Develop and maintain cross-walking and validation rules for file exchanges.
- Monitor incoming EDI issues and prioritize accordingly.
- Exhibit strong communication skills with both technical and business teams.
- Support internal teams in resolving issues, answering queries, and retransmitting EDI documents as necessary.
- Collaborate with end users to ensure thorough user acceptance testing.
- Demonstrate the ability to work independently with minimal supervision.
- Possess knowledge of Agile Methodology.
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