Job ID: IN-795706
Hybrid/Local EDI Developer (12+) with 835/837/210, HIPAA, SQL Server, IBM WTX, helpdesk and Healthcare/claims experience
Location: Indianapolis, IN (Indiana Department of Health Finance)
Duration: 3 Months
Skills:
Bachelor s Degree in Computer Science or related fields with IT experience Required
Database knowledge Required 5 Years
Understanding EDI file formats (835, 837, 210) 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
Description:
The IndianaDepartment of Health (IDOH) 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 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.
Never miss an opportunity! Create an alert based on the job you applied for.
