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.