What are the responsibilities and job description for the IT Lead EDI Specialist position at USM?
Position : IT Lead EDI Specialist
Location : Raleigh, NC - Hybrid
Duration : 12 Months
Internal Notes
- Client State of NC DHHS- IT Lead EDI Specialist
- Deadline : 10 / 30 / 2024
- Pay Rate : $50-52 Per HR on C2C
- 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.
- 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
- 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
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 :
Responsibilities
Specific RTR
By signing below, I [ ] acknowledge and agree that [USM Business Systems INC] has the sole right to represent me in matters of work assignment relating the NC IT Managed Services Contract by submitting my professional resume to the Contract's Managed Service Provider, Computer Aid, Inc . for the requirement identified below. I also acknowledge and verify that all the information contained in my resume related to my technical credentials is accurate and is based on educational training and professional experience obtained throughout my career. VectorVMS Requirement Number and Title (including Name of Agency) : USM SYSTEMS INC / DHHS- IT Lead EDI Specialist (750065)
Skill
Required / Desired
years Needed Amount
Possessed years of exp
Expert in developing and executing test scripts related to X12 EDI Transmission
Required
Years
Demonstrated proficiency in conducting QA and testing on EDI applications
Required
Years
Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
Required
Years
High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
Required
Years
Strong understanding of healthcare claims processing - Claims, Provider, Eligibility
Highly desired
Experience setting up users / new Trading Partner relationship / Standards / Envelope and full cycle testing
Required
Years
Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
Required
Years
Working knowledge of Medicaid and / or MMIS
Highly desired
Excellent verbal and written communication skills with the ability present to both technical and business audiences.
Desired
Proven experience in processing and monitoring all inbound and outbound X12 transactions
Required
Years
Knowledge of Agile Methodology
Required
Years
Experience in collaborating with EDI partners to resolve transmission problems.
Required
Years
LOCAL candidates only / Relocation
Required
Salary : $50 - $52
