Selected resource will be required to work onsite 3 days per week and 2 days remote
Candidate must be local to Indianapolis. Please provide current home address.
Job Description
The client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system ACAPS.
The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers at IDOH 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 IDOHs 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.
Provide support to healthcare providers who interact with IDOHs CSHCS system
Assist in onboarding new providers
Assist in onboarding new clearinghouses
Ability to work independently with less guidance and work with ISDH externals partners as needed.
Top Skills & Years of Experience
Required/Desired Skills
Skill
Required /Desired
Amount
of Experience
Bachelors Degree in Computer Science or related fields with IT experience
Required
0
Database knowledge
Required
5
Years
Understanding EDI file formats ()
Required
5
Years
Knowledge of HIPAA regulations
Required
0
Ability to solve complex troubleshooting issues
Required
0
Excellent verbal and written communication skills
Required
0
Health Industry experience
Highly desired
0
Knowledge of IBM Websphere (WTX)
Highly desired
0
Database/SQL experience
Highly desired
0
Recruiter Details:
Name :
Lokesh : Eight three two - Nine nine zero -Two four two six
Sameer : Seven one nine two three nine Five five five five
About US:
GSK Solutions Inc. is a premier information technology services company dedicated to delivering exceptional consulting solutions and staff augmentation to our valued clients. With an unwavering commitment to quality timeliness and budgetary considerations we consistently strive to exceed client expectations building a strong reputation through our reliable execution. Our expertise spans commercial and custom product development covering information security software development consulting and IT audits. We excel in managing critical time-sensitive projects for Fortune 500 clients nationwide ensuring their success is always at the forefront of our
Job Title: Senior EDI Developer (Hybrid) Location: Indianapolis IN Duration: 3 months Pay Rate: $59.06/hr on C2C / 1099 / W2 all inclusive Interview Process: Virtual and in-person Note: Selected resource will be required to work onsite 3 days per week and 2 day...
Job Title:
Senior EDI Developer (Hybrid)
Location:
Indianapolis IN
Duration:
3 months
Pay Rate:
$59.06/hr on C2C / 1099 / W2 all inclusive
Interview Process:
Virtual and in-person
Note:
Selected resource will be required to work onsite 3 days per week and 2 days remote
Candidate must be local to Indianapolis. Please provide current home address.
Job Description
The client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system ACAPS.
The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers at IDOH 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 IDOHs 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.
Provide support to healthcare providers who interact with IDOHs CSHCS system
Assist in onboarding new providers
Assist in onboarding new clearinghouses
Ability to work independently with less guidance and work with ISDH externals partners as needed.
Top Skills & Years of Experience
Required/Desired Skills
Skill
Required /Desired
Amount
of Experience
Bachelors Degree in Computer Science or related fields with IT experience
Required
0
Database knowledge
Required
5
Years
Understanding EDI file formats ()
Required
5
Years
Knowledge of HIPAA regulations
Required
0
Ability to solve complex troubleshooting issues
Required
0
Excellent verbal and written communication skills
Required
0
Health Industry experience
Highly desired
0
Knowledge of IBM Websphere (WTX)
Highly desired
0
Database/SQL experience
Highly desired
0
Recruiter Details:
Name :
Lokesh : Eight three two - Nine nine zero -Two four two six
Sameer : Seven one nine two three nine Five five five five
About US:
GSK Solutions Inc. is a premier information technology services company dedicated to delivering exceptional consulting solutions and staff augmentation to our valued clients. With an unwavering commitment to quality timeliness and budgetary considerations we consistently strive to exceed client expectations building a strong reputation through our reliable execution. Our expertise spans commercial and custom product development covering information security software development consulting and IT audits. We excel in managing critical time-sensitive projects for Fortune 500 clients nationwide ensuring their success is always at the forefront of our