Lead EDI Specialist/Tester

6 days ago

Raleigh, NC, United States Crescens Full time
Title: Lead EDI Specialist/Tester
Location: Raleigh, NC (Hybrid)
Duration: 6+ Months
Type: Contract

Note: Once COVID-19 restrictions are lifted, all work must be completed on site. Do you accept this requirement?

Description:
The client is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project. This position is responsible for the following activities related to a critical system being developed in-house at the State:
  • 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, TA1, 999, 820, NCPDP D.0
  • Develop and execute test scripts related to X12 Transmission Conducts QA and Testing on EDI application
  • Develop and execute Test scripts related to X12 Transmission 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.
  • Track day-to-day EDI & 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
  • Develops and maintains cross walking and validation rules for file exchanges
  • Triages incoming EDI issues thru monitoring
  • bility 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:
  • Expert in developing and executing test scripts related to X12 EDI transmissions
  • Demonstrated proficiency in QA and testing of EDI applications
  • Expert-level experience in EDI mapping for transactions including 837, 277CA, 834, 835, TA1, 999, 820, and NCPDP D.0
  • Strong business and technical knowledge with hands-on experience in HIPAA X12 EDI transactions
  • Solid understanding of healthcare claims processing, including Claims, Provider, and Eligibility workflows
  • Experience setting up users and new trading partner relationships, including standards, envelopes, and full-cycle testing
  • Experience creating and managing a catalog of EDI document types (837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0)
  • Working knowledge of Medicaid and/or MMIS systems
  • Proven experience processing and monitoring inbound and outbound X12 transactions
  • Experience collaborating with EDI trading partners to identify and resolve transmission issues
  • Knowledge of Agile methodology
  • Excellent verbal and written communication skills, with the ability to present to both technical and business audiences
  • Local candidate availability

  • IT EDI Tester

    4 days ago

    Raleigh, NC, United States My3Tech Inc Full time

    Hello, Hope you're doing good. Position: DHHS_IT EDI Tester Location: Dix Campus Raleigh North Carolina ( Remote ) Duration: Long Term Client: State of NC Job ID: (730341) Job Description: Local candidates only accepted. NC Dept of Health and Human Services (DHHS) is seeking a EDI Tester to perform QA and Testing work related to support the Managed Care...

  • IT EDI Tester

    1 week ago

    Raleigh, NC, United States My3Tech Inc Full time

    Hello, Hope you're doing good. Position: DHHS_IT EDI Tester Location: Dix Campus Raleigh North Carolina ( Remote ) Duration: Long Term Client: State of NC Job ID: (730341) Job Description: Local candidates only accepted. NC Dept of Health and Human Services (DHHS) is seeking a EDI Tester to perform QA and Testing work related to support the Managed Care...

  • IT EDI Tester

    7 days ago

    Raleigh, NC, United States My3Tech Inc Full time

    Hello, Hope you're doing good. Position: DHHS_IT EDI Tester Location: Dix Campus Raleigh North Carolina ( Remote ) Duration: Long Term Client: State of NC Job ID: (730341) Job Description: Local candidates only accepted. NC Dept of Health and Human Services (DHHS) is seeking a EDI Tester to perform QA and Testing work related to support the Managed Care...

  • DHHS- IT Lead EDI Specialist

    5 days ago

    Raleigh, NC, United States Abacus Full time

    Engagement Type: Contract Short Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project. Complete Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform...

  • DHHS- IT Lead EDI Specialist

    1 week ago

    Raleigh, NC, United States Abacus Full time

    Engagement Type: Contract Short Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project. Complete Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform...

  • DHHS- IT Lead EDI Specialist

    1 week ago

    Raleigh, NC, United States Abacus Full time

    Engagement Type: Contract Short Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project. Complete Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform...

  • DHHS- IT Lead EDI Specialist

    7 days ago

    Raleigh, NC, United States Abacus Full time

    Engagement Type: Contract Short Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project. Complete Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform...

  • DHHS- IT Lead EDI Specialist

    7 days ago

    Raleigh, NC, United States Abacus Full time

    Engagement Type: Contract Short Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project. Complete Description: NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform...

  • Lead EDI Tester

    5 days ago

    Raleigh, NC, United States InterSources Full time

    Responsibilities Expert in developing and executing test scripts related to X12 EDI Transmission Demonstrated proficiency in conducting 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...

  • IT Lead EDI Specialist

    5 days ago

    Raleigh, NC, United States MSys Inc Full time

    Interview Type: Webcam *** Very long term project; initial PO for 1 year, expect to go for 4+ years *** Hybrid *** Description: This position is responsible for the following activities related to a critical system being developed in-house at the State: Provides technical support during and after implementation for healthcare electronic data interchange...