What are the responsibilities and job description for the EDI Specialist position at Mitchell Martin?
Our client, a self-funded health plan solution with reference-based pricing and provider partners seeking for a EDI Specialist
Position Type: Contract
Location: Fully Remote – EST Preferred
SUMMARY:
The electronic data interchange (EDI) Specialist will work on a wide range of EDI projects utilizing X12 and proprietary data formats that require a wide set of skills from knowledge of Extract, Transform and Load tactics to creating meaningful business requirement documents.
The EDI Specialist will function as technology lead on EDI implementation projects.
Additionally, the EDI Specialist will partner with the business and all data-trading partners to support daily EDI processing and implementations.
Successful individuals will be able to effectively operate in a fast-paced environment, utilizing their excellent time management, communication, collaboration, and critical thinking skills in combination with their deep technical expertise to drive the success of their tasks from beginning to end.
DUTIES AND RESPONSIBILITIES:
• Support day-to-day EDI operations with hands on approach and passion for delivering best-in-class services to internal and external stakeholders.
• Work with internal and external clients to gather, analyze and document EDI requirements.
• Build new data import and export processes and modify/support existing data import and export processes based on business, client and vendor requirements. Formats include but are not limited to
• 837 claim feeds inbound and outbound
• 834 eligibility feeds both inbound and outbound
• Proprietary claim feeds both inbound and outbound
• Proprietary eligibility feeds both inbound and outbound
• Accumulator feeds both inbound and outbound
• Authorization / preauthorization imports
• Analyze the data exchanged with stakeholders in order to troubleshoot, record and address errors and implement corrections.
• Identify risk and failure points with a constant focus on process improvement and automation.
• Coordinate all EDI testing, implementations and upgrades. This includes but is not limited to QA and regression testing to ensure process and data accuracy.
• Documentation of processes and workflows.
• Other duties as assigned.
REQUIRED EXPERIENCE AND EDUCATION:
• Associate's degree in Business Administration, Computer Science, or equivalent from an accredited institution or equivalent experience
SKILLS AND ABILITIES Required:
• Experience with Gentran (preferred) or other EDI translation/transformation software.
• Knowledge of ANSI X12 standards and the ability to read and understand X12 EDI guides.
• Understanding of IT principles and business processes with an ability to communicate technical concepts effectively to a varied audience.
• Detail oriented with a problem-solving attitude.
• Ability to find creative solutions to technology challenges.
• Strong ability to effectively communicate both verbally and in writing.
• Ability to work with remote teams including working closely with business professionals as well as technical resources and acting as a bridge between the two groups including liaison with vendors.
• Possess excellent organizational, time management and follow-up skills.
• Demonstrates ability to work independently, take initiative and be self-motivated.
• Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy.
• Ability to make effective decisions under pressure and work in fast paced environment.
• Demonstrated ability to treat confidential information with discretion.
• Knowledge of healthcare industry.
*M
Position Type: Contract
Location: Fully Remote – EST Preferred
SUMMARY:
The electronic data interchange (EDI) Specialist will work on a wide range of EDI projects utilizing X12 and proprietary data formats that require a wide set of skills from knowledge of Extract, Transform and Load tactics to creating meaningful business requirement documents.
The EDI Specialist will function as technology lead on EDI implementation projects.
Additionally, the EDI Specialist will partner with the business and all data-trading partners to support daily EDI processing and implementations.
Successful individuals will be able to effectively operate in a fast-paced environment, utilizing their excellent time management, communication, collaboration, and critical thinking skills in combination with their deep technical expertise to drive the success of their tasks from beginning to end.
DUTIES AND RESPONSIBILITIES:
• Support day-to-day EDI operations with hands on approach and passion for delivering best-in-class services to internal and external stakeholders.
• Work with internal and external clients to gather, analyze and document EDI requirements.
• Build new data import and export processes and modify/support existing data import and export processes based on business, client and vendor requirements. Formats include but are not limited to
• 837 claim feeds inbound and outbound
• 834 eligibility feeds both inbound and outbound
• Proprietary claim feeds both inbound and outbound
• Proprietary eligibility feeds both inbound and outbound
• Accumulator feeds both inbound and outbound
• Authorization / preauthorization imports
• Analyze the data exchanged with stakeholders in order to troubleshoot, record and address errors and implement corrections.
• Identify risk and failure points with a constant focus on process improvement and automation.
• Coordinate all EDI testing, implementations and upgrades. This includes but is not limited to QA and regression testing to ensure process and data accuracy.
• Documentation of processes and workflows.
• Other duties as assigned.
REQUIRED EXPERIENCE AND EDUCATION:
• Associate's degree in Business Administration, Computer Science, or equivalent from an accredited institution or equivalent experience
SKILLS AND ABILITIES Required:
• Experience with Gentran (preferred) or other EDI translation/transformation software.
• Knowledge of ANSI X12 standards and the ability to read and understand X12 EDI guides.
• Understanding of IT principles and business processes with an ability to communicate technical concepts effectively to a varied audience.
• Detail oriented with a problem-solving attitude.
• Ability to find creative solutions to technology challenges.
• Strong ability to effectively communicate both verbally and in writing.
• Ability to work with remote teams including working closely with business professionals as well as technical resources and acting as a bridge between the two groups including liaison with vendors.
• Possess excellent organizational, time management and follow-up skills.
• Demonstrates ability to work independently, take initiative and be self-motivated.
• Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy.
• Ability to make effective decisions under pressure and work in fast paced environment.
• Demonstrated ability to treat confidential information with discretion.
• Knowledge of healthcare industry.
*M
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