Remote Healthcare EDI Specialist
Job title: Remote Healthcare EDI Specialist in New York City, NY at EDI Staffing
Company: EDI Staffing
Job description: *Candidates must reside in: AZ, CT, FL, GA, IL, IN, KS, KY, MI, NJ, NY, OH, OK, SC, TN, or TX*The EDI Specialist works with the company's Electronic Data Interchange program, facilitating the establishment of new customer/partner relationships within our EDI environment, including documenting requirements, testing solutions, and ensuring successful implementations.Responsibilities:
Monitor generation and transmission of both inbound and outbound EDI data; perform initial troubleshooting on all processes to resolve content issues and map problems.
Review/log failures, resolve data issues, and reload data. Collaborate with other departments as needed.
Pull and load files for non-automated processes.
Maintain EDI status tracking; prepare reports of results.
Maintain active relationships with internal and/or external stakeholders to develop business requirements.
Participate in meetings with stakeholders to gather and document requirements and explore potential solutions.
Work with development team to develop, define application scope and objectives, and prepare functional and/or technical specifications to accommodate business processes related to EDI.
Analyzes and classifies complex change request and identifies and documents possible system code enhancements.
Conduct and lead on all end-to-end testing phases with EDI Trading Partners and Business Users.
Assist in creating basic test scenarios to be used in testing the business applications to verify that client requirements are incorporated into the system design.
Identify, recommend, and implement process improvements in support of the EDI system.
Perform root cause analysis of any production issue and generate solutions to prevent recurrence.
Experience:
3+ years of EDI healthcare transaction processing for eligibility, clinical, claims, accumulator, and provider X12 data.
Knowledge of healthcare insurance industry claims and eligibility administration experience preferred.
Hands-on experience with EDI Healthcare X12 Transactions such as 837, 834, 835, 270/271, 278, 276/277, 999.
Knowledge of industry standard health data code sets such as ICD-10, CPT/HCPCS, revenue codes.
Knowledgeable with regulatory requirements associated with 5010 and ICD-10.
Specific knowledge of claims, enrollment, and /or authorizations.
Knowledge of EDI claims management platforms
Experience with Microsoft SQL Server or PostGREsql databases including writing queries
Communicate clearly and professionally with internal and external customers; including the ability to explain technical detail with non-technical counterparts.
Work effectively as part of a team to achieve established outcomes. Understand other's roles and empower one another to take responsibility to be successful. Demonstrate a collaborative interaction with peers to reach a common goal.
Demonstrate a collaborative interaction with peers to reach a common goal as well as be a resource to team members and internal/external customers.
Pay close attention to detail in all aspects of the job.
#LI-remote
Expected salary:
Location: New York City, NY
Apply for the job now!
Apply Now
Company: EDI Staffing
Job description: *Candidates must reside in: AZ, CT, FL, GA, IL, IN, KS, KY, MI, NJ, NY, OH, OK, SC, TN, or TX*The EDI Specialist works with the company's Electronic Data Interchange program, facilitating the establishment of new customer/partner relationships within our EDI environment, including documenting requirements, testing solutions, and ensuring successful implementations.Responsibilities:
Monitor generation and transmission of both inbound and outbound EDI data; perform initial troubleshooting on all processes to resolve content issues and map problems.
Review/log failures, resolve data issues, and reload data. Collaborate with other departments as needed.
Pull and load files for non-automated processes.
Maintain EDI status tracking; prepare reports of results.
Maintain active relationships with internal and/or external stakeholders to develop business requirements.
Participate in meetings with stakeholders to gather and document requirements and explore potential solutions.
Work with development team to develop, define application scope and objectives, and prepare functional and/or technical specifications to accommodate business processes related to EDI.
Analyzes and classifies complex change request and identifies and documents possible system code enhancements.
Conduct and lead on all end-to-end testing phases with EDI Trading Partners and Business Users.
Assist in creating basic test scenarios to be used in testing the business applications to verify that client requirements are incorporated into the system design.
Identify, recommend, and implement process improvements in support of the EDI system.
Perform root cause analysis of any production issue and generate solutions to prevent recurrence.
Experience:
3+ years of EDI healthcare transaction processing for eligibility, clinical, claims, accumulator, and provider X12 data.
Knowledge of healthcare insurance industry claims and eligibility administration experience preferred.
Hands-on experience with EDI Healthcare X12 Transactions such as 837, 834, 835, 270/271, 278, 276/277, 999.
Knowledge of industry standard health data code sets such as ICD-10, CPT/HCPCS, revenue codes.
Knowledgeable with regulatory requirements associated with 5010 and ICD-10.
Specific knowledge of claims, enrollment, and /or authorizations.
Knowledge of EDI claims management platforms
Experience with Microsoft SQL Server or PostGREsql databases including writing queries
Communicate clearly and professionally with internal and external customers; including the ability to explain technical detail with non-technical counterparts.
Work effectively as part of a team to achieve established outcomes. Understand other's roles and empower one another to take responsibility to be successful. Demonstrate a collaborative interaction with peers to reach a common goal.
Demonstrate a collaborative interaction with peers to reach a common goal as well as be a resource to team members and internal/external customers.
Pay close attention to detail in all aspects of the job.
#LI-remote
Expected salary:
Location: New York City, NY
Apply for the job now!
Apply Now