EDI Claims Implementation Specialist (Medicaid Migration)

Title: EDI Claims Implementation Specialist (Medicaid Migration)

Duration: 6 Months

Location: Latham, NY (Remote Locals Preferred)

Rate: $60/hr on W2

Role Overview:
We are seeking a specialized EDI Claims Implementation Specialist to support a critical system migration for a Massachusetts Medicaid client. This role is central to transitioning claims processing from a legacy system to a new platform, requiring a professional who understands the full lifecycle of a claim.

Key Responsibilities:

• Inbound Claims Bridging: Manage the intake and translation of inbound EDI files (837P/I), ensuring seamless data flow into the new adjudication system.
• Adjudication Support: Collaborate with configuration teams to address system impacts, ensuring claims adjudicate correctly under the new platform.
• Downstream Reporting: Oversee the generation of outbound encounter reporting (835/277CA), ensuring compliance with Massachusetts Medicaid regulations.