HybridDescription:The 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 client: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.0Develop and execute test scripts related to X12 TransmissionConducts QA and Testing on EDI applicationsDevelop and execute Test scripts related to X12 TransmissionExperience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testingProvides technical support during and after implementation for healthcare electronic data interchange applicationsResponds to inquiries regarding EDI issues with encounter claims and trading partner activitiesManagement of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0Communication between Trading Partners and departmentMaintain detailed documentation and process flow of all EDI processesIdentify and facilitate issues with partner data mapping from onset through completionProcess and monitor all inbound and outbound X12 transactionsSupport Customer Service group with EDI related issuesIdentifies, recommends and implements process improvements in support of the EDI systemTroubleshoot EDI document processing errors and work with trading partners directly to resolve in a timely matterConducts analysis of EDI transactions and is responsible for documentation and reportsCollaborate 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 managementEffectively communicate issues and needs with internal business partners, external vendors, and healthcare providersDevelops and maintains cross walking and validation rules for file exchangesTriages incoming EDI issues thru monitoringAbility to communicate effectively with technical and business staffSupport internal resources to resolve issues, answer questions, and retransmit EDI documents when necessaryWork with end users to ensure user acceptance testing is thorough and completeEmployees should be able to work independently with minimal supervision.Knowledge of Agile MethodologySkill - Required / Desired - Amount of ExperienceExpert in developing and executing test scripts related to X12 EDI Transmission - Required - 7 YearsDemonstrated proficiency in conducting QA and testing on EDI applications - Required - 5 YearsExpert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 - Required - 5 YearsHigh degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions. - Required - 5 YearsStrong understanding of healthcare claims processing - Claims, Provider, Eligibility - Highly desiredExperience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing - Required - 2 YearsExperience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 - Required - 3 YearsWorking knowledge of Medicaid and/or MMIS - Highly desired -Excellent verbal and written communication skills with the ability present to both technical and business audiences. - Desired -Proven experience in processing and monitoring all inbound and outbound X12 transactions - Required - 3 YearsKnowledge of Agile Methodology - Required - 2 YearsExperience in collaborating with EDI partners to resolve transmission problems. - Required - 2 YearsNotes:Hybrid VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Description:The 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 client: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.0Develop and execute test scripts related to X12 TransmissionConducts QA and Testing on EDI applicationsDevelop and execute Test scripts related to X12 TransmissionExperience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testingProvides technical support during and after implementation for healthcare electronic data interchange applicationsResponds to inquiries regarding EDI issues with encounter claims and trading partner activitiesManagement of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0Communication between Trading Partners and departmentMaintain detailed documentation and process flow of all EDI processesIdentify and facilitate issues with partner data mapping from onset through completionProcess and monitor all inbound and outbound X12 transactionsSupport Customer Service group with EDI related issuesIdentifies, recommends and implements process improvements in support of the EDI systemTroubleshoot EDI document processing errors and work with trading partners directly to resolve in a timely matterConducts analysis of EDI transactions and is responsible for documentation and reportsCollaborate 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 managementEffectively communicate issues and needs with internal business partners, external vendors, and healthcare providersDevelops and maintains cross walking and validation rules for file exchangesTriages incoming EDI issues thru monitoringAbility to communicate effectively with technical and business staffSupport internal resources to resolve issues, answer questions, and retransmit EDI documents when necessaryWork with end users to ensure user acceptance testing is thorough and completeEmployees should be able to work independently with minimal supervision.Knowledge of Agile MethodologySkill - Required / Desired - Amount of ExperienceExpert in developing and executing test scripts related to X12 EDI Transmission - Required - 7 YearsDemonstrated proficiency in conducting QA and testing on EDI applications - Required - 5 YearsExpert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 - Required - 5 YearsHigh degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions. - Required - 5 YearsStrong understanding of healthcare claims processing - Claims, Provider, Eligibility - Highly desiredExperience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing - Required - 2 YearsExperience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 - Required - 3 YearsWorking knowledge of Medicaid and/or MMIS - Highly desired -Excellent verbal and written communication skills with the ability present to both technical and business audiences. - Desired -Proven experience in processing and monitoring all inbound and outbound X12 transactions - Required - 3 YearsKnowledge of Agile Methodology - Required - 2 YearsExperience in collaborating with EDI partners to resolve transmission problems. - Required - 2 YearsNotes:Hybrid
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