IT Lead EDI Specialist

DataStaff, Inc. is currently seeking an IT Lead EDI Specialist for a long-term contract opportunity with one of our direct clients in Raleigh, NC.

*This position is hybrid
Responsibilities:

• 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
• Provide technical support during and after implementation for healthcare electronic data interchange applications.
• Respond to inquiries regarding EDI issues with encounter claims and trading partner activities.
• Manage catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0.
• Communicate 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.
• Identify, recommend and implement 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.
• Conduct analysis of EDI transactions and be responsible for documentation and reports.
• Collaborate with EDI partners to resolve transmission problems.
• Track day-to-day EDI and 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.
• Develop and maintain cross-walking and validation rules for file exchanges.
• Triage 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:

• 7 years: Expert in developing and executing test scripts related to X12 EDI Transmission
• 5 years: Demonstrated proficiency in conducting QA and testing on EDI applications
• 5 years: Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
• 5 years: High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions
• 2 years: Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing
• 3 years: Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
• 3 years: Proven experience in processing and monitoring all inbound and outbound X12 transactions
• 2 years: Knowledge of Agile Methodology
• 2 years: Experience in collaborating with EDI partners to resolve transmission problems.

Highly Desired Skills:

• Strong understanding of healthcare claims processing - Claims, Provider, Eligibility
• Working knowledge of Medicaid and/or MMIS
• Excellent verbal and written communication skills with the ability present to both technical and business audiences

This position is available on a corp-to-corp basis or as a W2 position with a competitive benefits package. DataStaff, Inc. offers medical, dental and vision coverage options as well as paid vacation, sick and holiday leave. As many of our opportunities are long-term, we also have a 401k program available for employees after 6 months.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.