14 Jan
Lead EDI Specialist / Tester
North Carolina, Raleigh / durham / CH , 27601 Raleigh / durham / CH USA

Vacancy expired!

Role: IT Lead EDI Specialist (643163)

Duration: 12 Months+

Location: Dix Campus Raleigh North Carolina

Interview Mode: Webcam Interview Only

Type: Contract

Start Date: 01/25/2021

Client is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition 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

Required 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
  • Vacancy expired!


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