| EDI Developer - Location: Hybrid or Onsite to Roseville is preferred at Roseville, Ohio, USA |
| Email: [email protected] |
| Role: EDI Developer Location: Hybrid or Onsite to Roseville is preferred Client: Adventist Health Visa: No H1b Transfers Experience: Minimum 12, Maximum 22 Here is the JD for the EDI developer - 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. Required Skills and Qualifications: 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 Qualifications: Experience in managing EDI implementations in a cloud-based environment. Knowledge of healthcare industry standards and workflows. Prior experience in EDI modernization projects. -- Keywords: information technology EDI Developer - Location: Hybrid or Onsite to Roseville is preferred [email protected] |
| [email protected] View all |
| Fri Sep 20 19:44:00 UTC 2024 |