HYBRID Senior EDI Developer 795706
Full-time
Universal Workforce Services
Must be a resident in Indianapolis IN.
Short Description:We are seeking an EDI expert in order to maintain and advance our clients health insurance claims processing system. Complete Description:
The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers are loaded into our database are adjudicated based on state and national pricing standards and as adjudication messages are generated and sent back to the originating provider. This position will work with the project manager software developers business analysts and functional team members on the project activities.
Essential Duties / Responsibilities:
- Review update all documentation related to claims processing and EDI transactions
- Identify incompletely documented claims processing and EDI processes and document them
- Work with development team as a SME as clients health insurance claims system is rewritten
- Act as liaison between OTC team and the Childrens program area on claims processing issues
- Working with technical and functional staff on detailed business requirements understanding business processes and technology agency standards federal and state policies to align with projects goals.
- Write technical specifications based on conceptual design and stated business requirements.
- Test new and existing systems
- Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.
- Provide helpdesk level support for EDI claim transactions.
- Provide support to healthcare providers who interact with clients CSHCS system
- Assist in onboarding new providers
- Assist in onboarding new clearinghouses
- Ability to work independently with little guidance and work withexternals partners as needed.
Requirements:
- Bachelors Degree in Computer Science or related fields with IT experience
- 5 years experience with database knowledge
- 5 years experience understanding EDI file formats ()
- Knowledge of HIPAA regulations
- Ability to solve complex troubleshooting issues
- Excellent verbal and written communication skills
Preferred skills:
- Health industry experience
- Knowledge of IBM Websphere (WTX)
- Database/SQL experience
Required Experience:
Senior IC
Vacancy posted 8 days ago
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