Electronic Data Interchange Specialist

MethodHub; Raleigh (NC); On-site; USD 80,000 - 110,000; Part time

Job summary

MethodHub is seeking a Lead EDI Specialist in Raleigh, North Carolina to support the Managed Care Transition Project. The role involves developing and executing test scripts, conducting QA on EDI applications, and handling various EDI transactions.

Ideal candidates will have practical experience with HIPAA X12 EDI Transactions and the ability to manage trading partner relationships. Candidates must work independently with minimal supervision and effectively communicate with technical and business teams.

Qualifications

• Significant practical experience in HIPAA X12 EDI Transactions.
• Experience in setting up users and trading partner relationships.
• Ability to work independently with minimal supervision.

Responsibilities

• Perform work related to the Managed Care Transition Project.
• Develop and execute test scripts related to X12 Transmission.
• Conduct QA and testing on EDI applications.

Skills

HIPAA X12 EDI Transactions

Test scripts development

QA and testing on EDI applications

Process improvements

Technical support for EDI applications

Job description

Local candidates only will be considered. Please state current city/state

Interview Type: Webcam Interview Only

Duration: 6 months

The client is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project.

This position is responsible for the following activities related to a critical system being developed in-house at the State.

Responsibilities

• High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
• Develop and execute test scripts related to X12 Transmission
• Conduct QA and testing on EDI applications
• Develop and execute test scripts related to X12 Transmission
• Experience setting up users/new trading partner relationships, standards, envelope and full cycle testing
• 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 manner
• 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 & 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 through monitoring
• 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.