Lead EDI Specialist
4 weeks ago
Job Summary:
Novalink Solutions is seeking a highly skilled Lead EDI Specialist to join our team. As a key member of our EDI team, you will be responsible for performing work related to support the Managed Care Transition Project and the Medicaid Reform Project.
Key Responsibilities:
• Develop and execute test scripts related to X12 EDI Transmission
• Conduct 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
• Strong understanding of healthcare claims processing - Claims, Provider, Eligibility
• 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.
Requirements:
• Expert in developing and executing test scripts related to X12 EDI Transmission (7 years of experience)
• Demonstrated proficiency in conducting QA and testing on EDI applications (5 years of experience)
• Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 (5 years of experience)
• High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions (5 years of experience)
• Strong understanding of healthcare claims processing - Claims, Provider, Eligibility (highly desired)
• Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing (2 years of experience)
• Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 (3 years of experience)
• Working knowledge of Medicaid and/or MMIS (highly desired)
• Excellent verbal and written communication skills with the ability present to both technical and business audiences (desired)
• Proven experience in processing and monitoring all inbound and outbound X12 transactions (3 years of experience)
• Knowledge of Agile Methodology (2 years of experience)
• Experience in collaborating with EDI partners to resolve transmission problems (2 years of experience)
What We Offer:
Novalink Solutions offers a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and experienced EDI professional looking for a new challenge, please submit your application.
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