Summary: We are expanding our Encounter Development team and seeking a Healthcare EDI Developer to support enterprise encounter reporting through timely, accurate generation and submission of 837D X12 encounter files.
Job Responsibilities
Execute recurring operational tasks to generate encounter data files; monitor daily production jobs, troubleshoot issues, and drive error investigation through resolution.
Design, build, and maintain X12 EDI 837 encounter processing workflows.
Ensure solutions comply with HIPAA and X12 standards, including state- and client-specific implementation guides.
Perform unit, integration, and regression testing for EDI processes and related data flows.
Interpret and reconcile 999, 277, 835, and custom state/client response files associated with encounter submissions.
Develop and maintain data mappings between internal application data models and EDI segments/loops.
Implement corrective actions to remediate defects and reduce or eliminate repeat issues.
Partner with external clients and internal operational teams on new client implementations and changes to existing submissions.
Create and execute EDI test plans and provide clear, timely status updates to internal stakeholders and clients.
Experience and Qualifications
3+ years of relevant experience in the healthcare industry, Dental preferred
3+ years of experience in a data analyst role, preferably supporting healthcare EDI.
1+ years of experience developing post-adjudication X12 837 files (required).
1+ years of SQL experience.
Working knowledge of HIPAA X12 standards, specifically the 837 claim/encounter transaction.
Strong attention to detail with the ability to analyze client needs and accurately document processes.
Excellent analytical, troubleshooting, and communication skills.
Experience with IBM Sterling B2B Integrator is preferred.
Never miss an opportunity! Create an alert based on the job you applied for.
