Primary Skills
EDI
Job Description
Need last 4 SSN, DL, and LinkedIn that matches resume!!
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.
Details.
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.
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