Create and maintain EDI system maps, trading partners and ezEDI configurations to meet the requirements of internal and external EDI data needs.
• Ensure and track the successful completion of compliance defined EDI submissions with partners and Health Plans.
• Facilitate process and quality improvement through identification and analysis of process and data exceptions; recommending solutions and producing reports
• Work directly with external and internal contacts to implement, modify and resolve issues related to sharing data via EDI or other electronic file submissions and receipts
• Perform other tasks as needed in the support of the operations department, particularly related to the interface between the EDI function and adjunct groups
---
Must have X12 EDI experience with 837, 997, 999, TA1. Both converting technical documentation into implementations and parsing/handling/routing errors based on context ( eligibility, data quality, required fields/trading partner rules)
Nice to have: X12 EDI 278, 834 experience
Must have Technical skills: Excel, File system automation and/or scripting (Ruby, Python, Powershell, Javascript), SFTP, T-SQL
Nice to have: JSON, XML, HL7 , Interface Engines (Next Gen Mirth, Viewpoint Rhapsody, Cloverleaf or similar)