IT Lead EDI Specialist

NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform Project. This position is responsible for the following activities related to a critical system being developed in\-house at the State: * High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions. * Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 * Develop and execute test scripts related to X12 Transmission * Conducts QA and Testing on EDI applications * Develop and execute Test scripts related to X12 Transmission * Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing * Provides technical support during and after implementation for healthcare electronic data interchange applications * Responds to inquiries regarding EDI issues with encounter claims and trading partner activities * Management of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 * Communication between Trading Partners and department * Maintain detailed documentation and process flow of all EDI processes * Identify and facilitate issues with partner data mapping from onset through completion * Process and monitor all inbound and outbound X12 transactions * Support Customer Service group with EDI related issues * Identifies, recommends and implements process improvements in support of the EDI system * Troubleshoot EDI document processing errors and work with trading partners directly to resolve in a timely matter * Conducts analysis of EDI transactions and is responsible for documentation and reports * Collaborate with EDI partners to resolve transmission problems. * Track day\-to\-day EDI \& batch processes to identify and address problems as they arise reporting levels of activity using key established metrics for senior management * Effectively communicate issues and needs with internal business partners, external vendors, and healthcare providers * Develops and maintains cross walking and validation rules for file exchanges * Triages incoming EDI issues thru monitoring * Ability to communicate effectively with technical and business staff * Support internal resources to resolve issues, answer questions, and retransmit EDI documents when necessary * Work with end users to ensure user acceptance testing is thorough and complete * Employees should be able to work independently with minimal supervision. * Knowledge of Agile Methodology **Skill Matrix:** * Expert in developing and executing test scripts related to X12 EDI Transmission Required 7 Years * Demonstrated proficiency in conducting QA and testing on EDI applications Required 5 Years * Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 Required 5 Years * High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions. Required 5 Years * Strong understanding of healthcare claims processing \- Claims, Provider, Eligibility Highly desired * Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing Required 2 Years * Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0m Required 3 Years * Working knowledge of Medicaid and/or MMIS Highly desired * Excellent verbal and written communication skills with the ability present to both technical and business audiences. Desired * Proven experience in processing and monitoring all inbound and outbound X12 transactions Required 3 Years * Knowledge of Agile Methodology Required 2 Years * Experience in collaborating with EDI partners to resolve transmission problems. Required 2 Years * LOCAL candidates only Required **Benefits at IntelliBee** * **Long\-Term Stability:** Join us on a multi\-year opportunities with room to grow. * **Comprehensive Health Coverage:** Access quality healthcare benefits to keep you and your family well. * **Future Planning:** Enroll in our 401(k) program and invest in your financial security. * **GC Assistance:** We support immediate Green Card processing, if required.