Crescens Inc. ยท 1 day ago
Electronic Data Interchange Specialist
Raleigh, NC
Contract
Hybrid
Senior LevelCrescens Inc. is seeking a Lead EDI Specialist / Tester to support the Managed Care Transition Project. This role involves working with HIPAA X12 EDI transactions, developing and executing test scripts, and providing technical support for healthcare electronic data interchange applications.
ConsultingInformation TechnologyStaffing Agency
No H1B
Hiring Manager
Suresh Murugesan
Responsibilities
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 application
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
Qualification
Required
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 application
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
Expert in developing and executing test scripts related to X12 EDI transmissions
Demonstrated proficiency in QA and testing of EDI applications
Expert-level experience in EDI mapping for transactions including 837, 277CA, 834, 835, TA1, 999, 820, and NCPDP D.0
Strong business and technical knowledge with hands-on experience in HIPAA X12 EDI transactions
Solid understanding of healthcare claims processing, including Claims, Provider, and Eligibility workflows
Experience setting up users and new trading partner relationships, including standards, envelopes, and full-cycle testing
Experience creating and managing a catalog of EDI document types (837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0)
Working knowledge of Medicaid and/or MMIS systems
Proven experience processing and monitoring inbound and outbound X12 transactions
Experience collaborating with EDI trading partners to identify and resolve transmission issues
Knowledge of Agile methodology
Excellent verbal and written communication skills, with the ability to present to both technical and business audiences
Local candidate availability
Company
Crescens Inc.
At Crescens Inc, we lead the way in US IT Staffing and Project Services, always staying one step ahead of our clients' expectations across North America.
Founded in 2002
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Sophia Samuel
CEO
Company data provided by crunchbase