Description

Responsibilities: 

• 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.
• Provide support to healthcare providers who interact with IDOH’s CSHCS system
• Assist in onboarding new providers
• Assist in onboarding new clearinghouses
• Ability to work independently with less guidance and work with ISDH externals partners as needed

Key Skills

Education

Bachelor's degree