Lead EDI Systems Specialist

2 weeks ago


Raleigh, North Carolina, United States Crescens Full time
Job Title: IT Lead EDI Specialist
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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