Lead EDI Specialist

4 weeks ago


Raleigh, North Carolina, United States Novalink Solutions Full time
Job Title: Lead EDI Specialist

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.
  • EDI Specialist Lead

    4 weeks ago


    Raleigh, North Carolina, United States LanceSoft Full time

    Job Title: EDI Specialist LeadJob Summary:LanceSoft is seeking a highly skilled EDI Specialist Lead to support the Managed Care Transition Project and the Medicaid Reform Project. The ideal candidate will have a high degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.Key Responsibilities: Develop...


  • Raleigh, North Carolina, United States V-Soft Consulting Group Full time

    Job Title: IT Lead EDI SpecialistJob Summary:V-Soft Consulting Group is seeking an IT Lead EDI Specialist to develop and execute test scripts related to X12 Transmission. The ideal candidate will have experience in conducting QA and testing on EDI applications, providing technical support during and after implementation, and communicating between Trading...


  • Raleigh, North Carolina, United States raag solutions Full time

    Job SummaryWe are seeking a highly skilled IT Lead EDI Specialist to join our team at Raag Solutions. The ideal candidate will have a strong background in EDI transactions, particularly in HIPAA X12, and experience with EDI mapping for various document types.Key ResponsibilitiesDevelop and execute test scripts related to X12 transmissionConduct QA and...

  • EDI Specialist Lead

    4 weeks ago


    Raleigh, North Carolina, United States HighCloud Solutions Full time

    HighCloud Solutions is seeking a highly skilled EDI Specialist Lead to support the Managed Care Transition Project.The ideal candidate will have a high degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.Expert in EDI mapping for 837 277CA 834 835 TANCPDP D.0Develop and execute test scripts related...

  • EDI Specialist

    4 weeks ago


    Raleigh, North Carolina, United States Novalink Solutions LLC Full time

    Job Title: Lead EDI SpecialistNovalink Solutions LLC 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 leading the implementation and maintenance of our EDI systems.Key Responsibilities:Lead the implementation and maintenance of EDI systemsDevelop and execute test scripts related to...

  • EDI Specialist

    4 weeks ago


    Raleigh, North Carolina, United States Crescens Full time

    Job Title: Lead EDI SpecialistJob Summary:Crescens is seeking a highly skilled EDI Technical Lead to join our team. As a key member of our operations team, you will be responsible for managing and maintaining our EDI systems, ensuring seamless data exchange with our trading partners.Key Responsibilities:Develop and execute test scripts related to X12 EDI...

  • Senior EDI Specialist

    4 weeks ago


    Raleigh, North Carolina, United States Crescens Full time

    Job Title: Senior EDI SpecialistJob Summary:Crescens is seeking a highly skilled Senior EDI Specialist to join our team. The ideal candidate will have extensive experience in EDI transactions, including HIPAA X12, and a strong understanding of EDI mapping and testing.Key Responsibilities: Develop and execute test scripts related to X12 transmission Conduct...

  • EDI Technical Lead

    4 weeks ago


    Raleigh, North Carolina, United States InterSources Full time

    EDI Technical LeadAs an EDI Technical Lead at InterSources Inc, you will be responsible for managing the EDI system and ensuring its smooth operation. Your primary focus will be on developing and executing test scripts related to X12 Transmission, conducting QA and testing on EDI applications, and managing the catalog of EDI document types.Key...

  • EDI Technical Lead

    4 weeks ago


    Raleigh, North Carolina, United States InterSources Full time

    EDI Technical LeadAs an EDI Technical Lead at InterSources, you will be responsible for conducting QA and testing on EDI applications, providing technical support during and after implementation for healthcare electronic data interchange applications.Key Responsibilities:Respond to inquiries regarding EDI issues with encounter claims and trading partner...


  • Raleigh, North Carolina, United States InterSources Full time

    Job SummaryInterSources is seeking an EDI Administrative Specialist to join their team. This role is responsible for managing EDI transactions, including setup, testing, and implementation. The successful candidate will have a strong understanding of EDI protocols and be able to communicate effectively with technical and business...


  • Raleigh, North Carolina, United States Crescens Full time

    Job Title: Senior EDI Applications SpecialistJob Summary:Crescens is seeking a highly skilled Senior EDI Applications Specialist to join our team. As a key member of our EDI team, you will be responsible for developing and executing test scripts related to X12 Transmission, conducting QA and testing on EDI applications, and providing technical support during...


  • Raleigh, North Carolina, United States Crescens Full time

    Crescens is seeking an experienced EDI Systems Specialist to support the Managed Care Transition Project. The successful candidate will possess a high degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.Key Responsibilities:Develop and execute test scripts related to X12 TransmissionConduct QA and...


  • Raleigh, North Carolina, United States LanceSoft Full time

    **Job Summary**LanceSoft is seeking a highly skilled EDI Specialist to perform work related to support the Managed Care Transition Project and the Medicaid Reform Project.Expertise in business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.Proficient in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP...


  • Raleigh, North Carolina, United States Scout Exchange Full time

    Job Title: Senior Pharmacy Business Analyst SpecialistScout Exchange is seeking a highly skilled Senior Pharmacy Business Analyst Specialist to lead Business and Technical Analysis related to the implementation of the Pharmacy Benefits Management (PBM) module.Key Responsibilities:Lead Business and Technical Analysis for the PBM module implementationWork with...


  • Raleigh, North Carolina, United States ALbert Energy Full time

    Job OverviewALbert Energy is seeking a highly skilled Lead Protection Specialist to join our Power Delivery Group. The ideal candidate will have extensive experience in substation system protection and control design, with a strong background in electrical engineering and a proven track record of delivering high-quality projects.Key ResponsibilitiesPerform...


  • Raleigh, North Carolina, United States Accentuate Staffing Full time

    Customer Service Team LeadWe are seeking a highly organized and energetic Customer Service Team Lead to motivate and develop Customer Service Specialists, with a focus on maximizing customer experience performance and achieving service levels and overall productivity. The ideal candidate will have excellent leadership skills and be able to manage quality...

  • Senior Technical Lead

    4 weeks ago


    Raleigh, North Carolina, United States Cynet Systems Full time

    Job Overview:The Cynet Systems Web Systems Team is seeking a highly skilled Technical Specialist to lead Business owners in translating customer requests into technical requirements and user stories. This position will coordinate software and release schedules with Business and Technical Teams, develop business requirements, facilitate change management...


  • Raleigh, North Carolina, United States Crescens Full time

    Job Title: Senior Pharmacy BA SpecialistLocation: HybridDuration: 11+ monthsType: ContractJob Description:The Client is seeking a senior Business Analyst with technical expertise to assist with implementing and supporting the Medicaid Enterprise System (MES) Pharmacy Benefits Management (PBM) module.The PBM Business Analyst works with the Product owner,...


  • Raleigh, North Carolina, United States Valet Living Full time

    Job SummaryWe are seeking a highly motivated and organized Part-time Lead Waste Management Specialist to join our team at Valet Living. As a key member of our operations team, you will be responsible for managing the daily waste collection process, ensuring timely and efficient service delivery to our residents.Key ResponsibilitiesManage the daily waste...


  • Raleigh, North Carolina, United States Extend Information Systems Inc. Full time

    We are seeking a highly skilled Java Lead With Drools Expert to join our team at Extend Information Systems Inc.The ideal candidate will have in-depth hands-on experience in Java Full Stack Development and a strong background in Drools development.As a Senior Java Developer - Drools Specialist, you will be responsible for leading development efforts and...