Engagement Type
Contract
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 IDOH s ACAPS system is rewritten in .Net
Act as liaison between OTC team and the Children s 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 project s 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 IDOH s 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.
Required/Desired Skills
| Skill | Required/Desired | Amount | of Experience |
| Bachelor s Degree in Computer Science or related fields with IT experience | Required | | |
| Database knowledge | Required | 5.0 | Years |
| Understanding EDI file formats (835, 837, 210) | Required | 5.0 | 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 | | |
Never miss an opportunity! Create an alert based on the job you applied for.
