Company:
Partners Consulting, Inc.
Location: Philadelphia
Closing Date: 19/11/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
Title: EDI Specialist
Location: Philadelphia, PA
Type: Contract
Our client is seeking an EDI Specialist with extensive knowledge of EDI Portal and managing inbound EDI enrollment file activity. The EDI Specialist will ensure successful transfer of inbound EDI enrollment data to include troubleshooting and reconciliation of data integrity issues.
Key Accountabilities:
Responsible for managing EDI file activity for high-profile / complex EDI client business (BPO, Shared Services, non-standard, etc.).
Direct contact between EDI senders, clients, Account Management teams, Customer Experience teams, BizTalk / .Net teams, and project teams.
Responsible for supporting project work within the business area (leads and/or participates in project meetings, sprint work, business requirement documentation, system upgrades, and business checkouts).
Responsible for managing all robotic process automation (RPA) work for the business area.
Responsible for providing support to the Department's Business Systems Analyst with client-specific EDI enrollment testing.
Assists in the development of user system documentation and desk level procedures.
Manages daily team inventory activity and provides support, training, and/or direction to Eligibility Specialist team members.
Supports enrollment-related issues resolution as Enrollment Resolver Group participant.
Organizes/disperses team project work to other team members.
Assists with manual enrollment processing for all lines of business.
Supports Member Enrollment System platform (to include development work, inquiries, and EDI file activity).
Meets departmental quality and production standards.
Other duties as assigned by the Leadership Team.
Education & Experience
Bachelor's degree in Business Administration, Management Information Systems, or Computer Science; or equivalent work experience in the Healthcare/Technology space.
In lieu of a degree, a minimum 2 to 3 years of proven EDI / eligibility experience.
Understanding of XML / ANSI 834 / HIPAA X12 transactions is preferred.
Knowledge Summary
Ability to work with multiple business systems and has a general understanding of system design.
Knowledgeable of Microsoft office products.
Effective oral and written communications skills are necessary.
Must have a general understanding of the business environment and associated systems.
Must be detail oriented with a general understanding of corporate business systems.
Must be able to work independently with assigned tasks.
Ability to investigate, perform preliminary testing, and present findings.
Technical writing skills needed.
Must have related enrollment experience in the Health Rules system platform and a full understanding of the Front Office System as well as how these platforms interact with EDI Portal for EDI enrollment validation.
Strong analytical skills are required
#prt123
REQ-(phone number removed)
Location: Philadelphia, PA
Type: Contract
Our client is seeking an EDI Specialist with extensive knowledge of EDI Portal and managing inbound EDI enrollment file activity. The EDI Specialist will ensure successful transfer of inbound EDI enrollment data to include troubleshooting and reconciliation of data integrity issues.
Key Accountabilities:
Responsible for managing EDI file activity for high-profile / complex EDI client business (BPO, Shared Services, non-standard, etc.).
Direct contact between EDI senders, clients, Account Management teams, Customer Experience teams, BizTalk / .Net teams, and project teams.
Responsible for supporting project work within the business area (leads and/or participates in project meetings, sprint work, business requirement documentation, system upgrades, and business checkouts).
Responsible for managing all robotic process automation (RPA) work for the business area.
Responsible for providing support to the Department's Business Systems Analyst with client-specific EDI enrollment testing.
Assists in the development of user system documentation and desk level procedures.
Manages daily team inventory activity and provides support, training, and/or direction to Eligibility Specialist team members.
Supports enrollment-related issues resolution as Enrollment Resolver Group participant.
Organizes/disperses team project work to other team members.
Assists with manual enrollment processing for all lines of business.
Supports Member Enrollment System platform (to include development work, inquiries, and EDI file activity).
Meets departmental quality and production standards.
Other duties as assigned by the Leadership Team.
Education & Experience
Bachelor's degree in Business Administration, Management Information Systems, or Computer Science; or equivalent work experience in the Healthcare/Technology space.
In lieu of a degree, a minimum 2 to 3 years of proven EDI / eligibility experience.
Understanding of XML / ANSI 834 / HIPAA X12 transactions is preferred.
Knowledge Summary
Ability to work with multiple business systems and has a general understanding of system design.
Knowledgeable of Microsoft office products.
Effective oral and written communications skills are necessary.
Must have a general understanding of the business environment and associated systems.
Must be detail oriented with a general understanding of corporate business systems.
Must be able to work independently with assigned tasks.
Ability to investigate, perform preliminary testing, and present findings.
Technical writing skills needed.
Must have related enrollment experience in the Health Rules system platform and a full understanding of the Front Office System as well as how these platforms interact with EDI Portal for EDI enrollment validation.
Strong analytical skills are required
#prt123
REQ-(phone number removed)
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