Lead EDI Specialist

Company:  Resource Informatics Group
Location: Raleigh
Closing Date: 29/11/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
Lead EDI Specialist

Raleigh, NC - Hybrid - Locals preferred

Client: (phone number removed)

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.
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