Description

• Review update all documentation related to claims processing and EDI transactions

• Identify incompletely documented claims processing and EDI processes, and document them

• Work with development team as a SME as IDOH’s ACAPS system is rewritten in .Net

• Act as liaison between OTC team and the Children’s program area on claims processing issues

• Working with technical and functional staff on detailed business requirements, understanding business processes and technology, agency standards, federal and state policies to align with project’s goals.

• Write technical specifications based on conceptual design and stated business requirements.

• Test new and existing systems

• Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.

• Provide helpdesk level support for EDI claim transactions.

o Provide support to healthcare providers who interact with IDOH’s CSHCS system

o Assist in onboarding new providers

o Assist in onboarding new clearinghouses

• Ability to work independently with less guidance and work with ISDH externals partners as needed

Key Skills

Education

Any Gradute