client- IT Lead EDI Specialist

NC Dept of Health and Human Services (client) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project.

NC Dept of Health and Human Services (client) 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:
• 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
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• 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/Desired Skills

SkillRequired /DesiredAmountof ExperienceExpert in developing and executing test scripts related to X12 EDI TransmissionRequired7YearsDemonstrated proficiency in conducting QA and testing on EDI applicationsRequired5YearsExpert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0Required5YearsHigh degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.Required5YearsStrong understanding of healthcare claims processing - Claims, Provider, EligibilityHighly desired0Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testingRequired2YearsExperience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 Required3YearsWorking knowledge of Medicaid and/or MMISHighly desired0Excellent verbal and written communication skills with the ability present to both technical and business audiences.Desired0Proven experience in processing and monitoring all inbound and outbound X12 transactionsRequired3YearsKnowledge of Agile MethodologyRequired2YearsExperience in collaborating with EDI partners to resolve transmission problems.Required2YearsLOCAL candidates onlyRequired0
Questions

No.QuestionQuestion1Absences greater than two weeks MUST be approved by CAI management in advance, and contact information must be provided to CAI so that the resource can be reached during his or her absence. The Client has the right to dismiss the resource if he or she does not return to work by the agreed upon date. Do you accept this requirement?Question2Once COVID-19 restrictions are lifted, all work must be completed on site. Do you accept this requirement? Question3Please list candidate's email address HERE that will be used when submitting E-RTR. Question4Please indicate how soon this candidate is available to start work. The candidate should be able to start immediately to meet the Federal mandate and schedule. Question5Vendor must disclose to the agency if the candidate will be subcontracted at the time of submission. Do you accept this requirement? Question6Vendor must notify the agency if any portion of the requirements listed in this task order are to be outsourced to other countries. Do you accept this requirement? Question7Candidates submitted above the rate of $$1 will not be considered. Do you accept this requirement?Question8Please confirm you have thoroughly validated, and attest to the accuracy of, the credentials listed throughout this candidate's VectorVMS profile and resume pursuant to Section 5.2.5 of ITS-009440. Do you confirm?Question9Local candidates only will be considered. Please state current city/state.