EDI Specialist

3 days ago


Raleigh, NC, United States STI Full time
Job title: DHHS- IT Lead EDI Specialist

Location: Dix Campus Raleigh North Carolina

Duration: 9+ Months from projected
Job Description:
• 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 applications

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

• Ability 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

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