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Hiring EDI Developer at Roseville, California, USA
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Role: EDI Developer

Location: Roseville, CA 95661 (Onsite) 
Need Local

Client Adventist Health

NO H1B, CPT, OPT

Job Description: 

We are looking for an experienced Healthcare EDI Developer to join our dynamic team. The ideal candidate will possess strong expertise in implementing, managing, and supporting EDI transactions specific to the healthcare domain. You will play a key role in ensuring the seamless exchange of healthcare data, optimizing processes, and maintaining compliance with industry standards such as HIPAA.

Key Responsibilities

Develop, implement, and maintain EDI solutions that support healthcare-related transactions

Work with stakeholders to map and define EDI processes in accordance with business needs

Ensure the successful processing of Healthcare EDI transactions including but not limited to:

834: Benefit Enrollment and Maintenance

837: Health Care Claims (Professional, Institutional, and Dental)

270/271: Eligibility, Coverage, or Benefit Inquiry and Response

276/277: Health Care Claim Status Request and Response

835: Health Care Claim Payment/Remittance Advice

820: Health Insurance Premium Payment

275: Patient Information

278: Health Care Services Review

Collaborate internal teams to resolve transaction issues and ensure data accuracy

Conduct regular testing, validation, and troubleshooting of EDI systems to meet regulatory and operational requirements

Monitor transaction activity to ensure the integrity of EDI processing

Prepare and maintain technical documentation for all processes and system integrations

Ensure compliance with HIPAA standards and other regulatory guidelines

Participate in system upgrades, migration, and EDI enhancements

Skills and Experience

Minimum 5+ years of experience in EDI development, particularly in the Healthcare domain

Strong knowledge of healthcare EDI transactions (834, 837, 270/271, 276/277, 835, 820, 275, 278)

Experience with EDI mapping tools and translators (e.g., Sterling Integrator, Gentran, BizTalk, etc.)

Proficiency in EDI formats including X12 and HL7

Solid understanding of HIPAA requirements and data privacy regulations

Experience in working with various healthcare organizations, payers, providers, and clearinghouses

Strong problem-solving skills and ability to troubleshoot EDI processing errors

Familiarity with databases (SQL, Oracle) and scripting for EDI process automation

Excellent communication skills with the ability to collaborate effectively with cross-functional teams

Preferred/Big Plus

Experience in managing EDI implementations in a Cloud-based environment and EDI modernization projects

Knowledge of Healthcare industry standards and workflows

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Thanks & Regards,

Abhinav

Direct - 216 435 6682

Mail id - [email protected]

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Keywords: information technology California Idaho
Hiring EDI Developer
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Wed Sep 18 23:47:00 UTC 2024

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Location: Roseville, California