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Lead EDI Specialist, Raleigh, NC, Client: State of North Carolina at Raleigh, North Carolina, USA
Email: [email protected]
Hi,

Please find my direct client job requirements for your consideration.

Title: Lead EDI Specialist

Location: Raleigh, NC  

(
Hybrid
)

Duration:  12 Months 

Client: State of North Carolina

Job ID: 740848

Note: State Experience Preferred

Job 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
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 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

 SKILLS:

Skill

Required / Desired

Amount

of Experience

Expert in developing and executing test scripts related to X12 EDI Transmission

Required

7

Years

Demonstrated proficiency in conducting QA and testing on EDI applications

Required

5

Years

Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0

Required

5

Years

High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.

Required

5

Years

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

Required

2

Years

Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0

Required

3

Years

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

Required

3

Years

Knowledge of Agile Methodology

Required

2

Years

Experience in collaborating with EDI partners to resolve transmission problems.

Required

2

Years

LOCAL candidates only

Required

Please provide me below information Along with DL and Visa Copy:

Full Name:

Email ID:

Phone Number: (No google number)

SSN last 4:

Address:

Availability:

Availability for Interview:

Visa Status:

Passport no:

LinkedIn ID:

Visa Expiry date (MM/DD/YYYY):

Relocation:

Rate:

Professional Reference :1

Full Name:        

Company Name:            

Title:    

Telephone:       

Email id:

Keywords: quality analyst materials management Idaho North Carolina
Lead EDI Specialist, Raleigh, NC, Client: State of North Carolina
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Mon Jun 24 23:55:00 UTC 2024

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