EDI Lead

New York City, NY - USA

Monthly Salary: Not Disclosed

Posted on: 4 hours ago

Vacancies: 1 Vacancy

Job Summary

EDILead - Remote

Job Summary
TheEDILead manages and is responsible for the overallEDI/Interoperability process. This position is responsible for managing planning and guiding dailyEDIoperations and ensuring that trading partners contracted networks hospitals government agencies and provider transactions (X12 HL7 NCPDP Proprietary FHIR) are compliant with HIPAA CMS DHCS and DMHC mandates regulations and policies.
This role serves as a liaison between internal business units for allEDI/Interoperability requirements including eligibility provider data claims clinical data and encounters. TheEDILead also develops and provides oversight ofEDI/Interoperability processes and documentation and is responsible for allEDI/Interoperability-related projects. The position managesEDIpriorities and assignments in coordination with IT Applications Managers and the Director.
Knowledge Skills and Abilities

In-depth knowledge of HIPAA/EDIX12 5010 healthcare file formats
Knowledge of HL7 and FHIR formats
Strong data analysis and discrepancy resolution skills
Ability to work independently and in team environments
Strong verbal written and oral communication skills
Advanced analytical and problem-solving skills
Proficiency in English grammarediting and proofreading
Demonstrated leadership and cross-functional coordination skills
General PC and Microsoft Office proficiency

Education and Experience

Bachelors degree or higher or equivalent industry experience
57 years of experience as anEDIAnalyst
Experience with QNXT and/or other Cognizant solutions
57 years of experience withEdifecs products (preferred)
Strong MS Office skills (Outlook Word Excel PowerPoint)
Healthcare organization or health plan experience preferred
Experience implementing new systems preferred
Familiarity with healthcare managed care or Medi-Cal terminology preferred

EDILead - RemoteJob SummaryTheEDILead manages and is responsible for the overallEDI/Interoperability process. This position is responsible for managing planning and guiding dailyEDIoperations and ensuring that trading partners contracted networks hospitals government agencies and provider transactio...