Description

You will own EDI transaction processing, troubleshooting, and integration for healthcare claims.

Responsibilities

• Review and update documentation for claims processing and EDI transactions.
• Identify gaps in existing documentation and create detailed specifications for business requirements.
• Ensure accurate file exchanges with external trading partners and resolve EDI data transmission conflicts.
• Provide helpdesk-level support for EDI claim transactions and assist in onboarding new providers and clearinghouses.
• Act as a liaison between technical staff and business teams to align project goals with agency standards.

Required Skills

• 5+ years of experience with EDI file formats (835, 837, 210).
• Strong understanding of HIPAA regulations and health industry compliance.
• Proficiency in SQL and database management.
• Ability to troubleshoot complex technical issues independently.
• Bachelor’s degree in Computer Science or a related field.
• Excellent verbal and written communication skills.

Preferred Skills

• Experience with IBM WebSphere (WTX).
• Direct health industry experience.

Key Skills

Education

Bachelor's degree