IT Lead EDI Specialist

Job Title: IT Lead EDI Specialist

Location with zip code: Raleigh, NC 27603

Duration: Full Time:

Schedule: Health and Human Services is seeking a Lead EDI Specialist to perform work related to supporting the Medicaid Reform Project.

Job Description:

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

Required Qualifications:

• Expert in developing and executing test scripts related to X12 EDI Transmission.
• Demonstrated proficiency in conducting QA and testing on EDI applications.
• Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
• High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
• Strong understanding of healthcare claims processing - Claims, Provider, Eligibility.
• Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing
• Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
• Working knowledge of Medicaid and/or MMIS.
• Excellent verbal and written communication skills with the ability present to both technical and business audiences.
• Proven experience in processing and monitoring all inbound and outbound X12 transactions
• Knowledge of Agile Methodology.
• Experience in collaborating with EDI partners to resolve transmission problems.
• LOCAL candidates only.