- 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
- 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
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DHHS- IT Lead EDI Specialist
6 days ago
NR Consulting Wilmington, United StatesShort Description: · 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. · Complete Description: · NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Speciali ...
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Priority Worldwide Hanover, United StatesJob DetailsJob TypeFull-timeHanover, MDDescriptionPriority Worldwide is a full-service logistics provider operating around the globe. Our philosophy is to ensure the Ultimate Customer Experience and facilitate the creation of new, sustainable business through enhanced team cooper ...
DHHS- IT Lead EDI Specialist - Wilmington, United States - NR Consulting
Description
Short Description:
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.
Complete 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:Develop and execute Test scripts related to X12 Transmission
Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing