Senior EDI Developer

Indianapolis, IN - USA

Monthly Salary: Not Disclosed

Posted on: 8 days ago

Vacancies: 1 Vacancy

Job Summary

(Local candidates only as F2F Interview is must)

The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers are loaded into our database are adjudicated based on state and national pricing standards and as adjudication messages are generated and sent back to the originating provider. This position will work with the project manager software developers business analysts and functional team members on the project activities.

Essential Duties / Responsibilities:

Review update all documentation related to claims processing and EDI transactions

Identify incompletely documented claims processing and EDI processes and document them

Work with development team as a SME as ACAPS system is rewritten

Act as liaison between OTC team and the Childrens program area on claims processing issues

Working with technical and functional staff on detailed business requirements understanding business processes and technology agency standards federal and state policies to align with projects goals.

Write technical specifications based on conceptual design and stated business requirements.

Test new and existing systems

Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.

Provide helpdesk level support for EDI claim transactions.

o Provide support to healthcare providers who interact with CSHCS system

o Assist in onboarding new providers

o Assist in onboarding new clearinghouses

Ability to work independently with less guidance and work with ISDH externals partners as needed.

Skill	Required / Desired	Amount	of Experience
Bachelors degree in computer science or related fields with IT experience	Required
Database knowledge	Required	5	Years
Understanding EDI file formats ()	Required	5	Years
Knowledge of HIPAA regulations	Required
Ability to solve complex troubleshooting issues	Required
Excellent verbal and written communication skills	Required
Health Industry experience	Highly desired
Knowledge of IBM Websphere (WTX)	Highly desired
Database/SQL experience	Highly desired

(Local candidates only as F2F Interview is must) The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers are loaded into our database are adjudicated based on state and national pricing standards and as adjudication messages are generated an...