"Alerted.org

Interview Type: Webcam *** Very long term project; initial PO for 1 year, expect to go for 4+ years *** Hybrid ***

Description:

This position is responsible for the following activities related to a critical system being developed in-house at the State:

+ 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

+ 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

+ 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

+ 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.

Required Skills:

+ Expert in developing and executing test scripts related to X12 EDI Transmission. 7 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. 5 Years

+ Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing. 2 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. 3 Years

+ Knowledge of Agile Methodology. 2 Years

+ Experience in collaborating with EDI partners to resolve transmission problems. 2 Years

+ LOCAL candidates only

Highly Desired Skills:

+ Strong understanding of healthcare claims processing - Claims, Provider, Eligibility

+ Working knowledge of Medicaid and/or MMIS

Desired Skills:

+ Excellent verbal and written communication skills with the ability present to both technical and business audiences.