Position is responsible for all EDI processing and implementation. Must have knowledge and familiarity with HIPAA rules and guidelines as well as the requirements for processing 834, 835, 837, 270, 271, 276 and 277 transactions.Reports to: Chief Information OfficerRequirements:• 5+ years experience processing EDI files and coordinating trading partner implementation• Bachelor’s degree or significant work experience in the healthcare field.• Direct experience with Medicaid or managed care programs is preferred.• Excellent interpersonal skills with the ability to work cross-functionally with various levels of staff.• Excellent verbal and written communication skills.• Strong presentation and organizational skills.Duties and Responsibilities:• Perform daily operation of the EDI software systems• Monitor transmission reports and interfacing with trading partners• Retrieving, loading, reviewing, processing, researching and working failed records from the electronic eligibility files• Coordination of EDI testing and trading partner implementation• Troubleshooting EDI errors• Monitor all daily inbound and outbound transmissions• Create and update 837 encounter files for review• Process 834 files• Establish and implement policies and procedures that are EDI/HIPAA compliant, as necessary• Develop and maintain EDI documentation• Enter, maintain and update customer data• Respond to written inquiries and phone inquiries from CMOs, employer groups and internal customers• Establish and maintain production levels and quality goals.

Responsible for the accuracy and timeliness of the daily process of EDI transactions. Assist with the analysis, design and development of specifications for enhancement and extensions with EDI application interfaces and maps. Coordinate EDI testing and Trading Partner Implementation. Act as liaison between Trading Partners and Business operations. Perform system configuration, mapping and management of EDI transaction. Modify existing maps based on client or providers changes. Troubleshoot all EDI errors. Monitor all daily inbound and outbound transmissions. Perform data audits and quality control measures. Review and implement EDI system patches. Create Microsoft Access queries of the Visual Claim Databases. Knowledge of 837,270,271,278 X12 Transaction Sets. Establish and implement policies and procedures that are EDI HIPAA Complaint. Knowledge of HIPAA procedures and policies. Develop and maintain EDI documentation

Supervised a team of four EDI coordinators. Train team to become functional in EDI. Conducted annual employee performance reviews. Performed testing and configuration for SAP EDI implementation. Developed test cases and prepare test data with multiple sets of data. Solid development of functional test scripts and test scenarios. Used WinRunner automated scripts in day to day work. Analyze and interpret test results. Troubleshooted EDI malfunctions. SAP configuration of output determination, trading partner profiles and number conversions, IDOC maintenance and workflow. Responsible for the maintenance and development of trading partners, inbound or outbound. Knowledge of user exits and extensions in SAP IDOC processing functional modules.

EDI implementation. Developed test cases and prepare test data with multiple sets of data. Solid development of functional test scripts and test scenarios. Used WinRunner automated scripts in day to day work. Perform functional testing. Analyzed and interpret test results. Troubleshoot EDI malfunctions. SAP configuration of output determination, trading partner profiles and number conversions, IDOC maintenance and workflow.

Assisted on small; EDI, Web and client-server development projects. Coordinated EDI for a select group of vendors for Accounts Payable EDI Services Team. Performed detailed and time-sensitive, routine Electronic Interfaces. Handle internal and external customer inquiries. Work with new vendors to bring them on EDI. Knowledge and experience of X12, EDIFACT and XML EDI. Also inbound 110,810, 820, 821,824 and 827. Outbound 820,850 and 860.Troubleshoot EDI malfunctions.

Administered over $750,000 in rent and utility payments per day. Audited check payments and vendor history. Analyzed lease agreements to ensure accurate disbursement of payments. Generated a report to improve the accuracy of locating vendor numbers. Communicated with varying levels of internal and external management.

Maintained and updated electronic filing of accounts payable mailbox. Analyzed record retrieval documents. Performed system administration maintenance and problem solving.

Maintained and updated electronic filing of accounts payable mailbox. Analyzed record retrieval documents. Performed system administration maintenance and problem solving.