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EDI Tester (Medicaid) : Raleigh, NC : 12 Months Contract at Raleigh, North Carolina, USA
Email: [email protected]
From:

Jitendra Upreity,

Technocraft Solutions

[email protected]

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Job Title: EDI Tester (Medicaid)

Location: Raleigh, NC

Duration: 12 Months Contract

Note: Initial Remote: Due to COVID-19, the client has agreed to allow the selected candidate to work remotely for the time being. However, the selected candidate must be available to report onsite as directed by the client. Do you accept this requirement

Responsibilities and Skills:

Job ID: 717970

Location: Raleigh, NC (NCDHHS-AM)

Duration: 12 Months

Skills

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

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.

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

Keywords: quality analyst access management Idaho North Carolina
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Wed Aug 16 21:01:00 UTC 2023

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Location: Raleigh, North Carolina