Description

The NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to support the Managed Care Transition Project. This role requires a strong blend of business and technical expertise, particularly in HIPAA X12 EDI Transactions. The successful candidate will be responsible for EDI mapping, developing test scripts, quality assurance, and providing technical support for healthcare electronic data interchange applications.

Compensation and Benefits

• W-2 Rate - up to $45 per hour

Why you should apply for this position today

This position offers an excellent opportunity to work on critical healthcare projects that impact the managed care system. As a Lead EDI Specialist, you will play a vital role in ensuring the effective exchange of healthcare data, thereby contributing to improved patient care.

Skills

• High degree of business and technical knowledge of HIPAA X12 EDI Transactions
• Expertise in EDI mapping for transactions such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
• Ability to develop and execute test scripts related to X12 Transmission
• Experience in setting up users/new Trading Partner relationships and full cycle testing
• Strong troubleshooting skills for EDI document processing errors
• Excellent communication skills to liaise with trading partners and internal teams
• Knowledge of Agile Methodology

Responsibilities

• Develop and execute test scripts related to X12 Transmission
• Conduct quality assurance and testing on EDI applications
• Provide technical support during and after the implementation of EDI applications
• Respond to inquiries regarding EDI issues with encounter claims and trading partner activities
• Manage a catalog of EDI document types
• Communicate effectively with trading partners and internal departments
• Maintain detailed documentation of all EDI processes
• Identify and facilitate issues with partner data mapping
• Process and monitor inbound and outbound X12 transactions
• Support the Customer Service group with EDI-related issues
• Recommend and implement process improvements for the EDI system
• Analyze EDI transactions and prepare documentation and reports
• Collaborate with EDI partners to resolve transmission problems
• Monitor day-to-day EDI & batch processes, reporting levels of activity to senior management
• Ensure thorough and complete user acceptance testing with end users
• Work independently with minimal supervision

Qualifications

• Experience in EDI transactions and healthcare data exchange
• Proven ability to communicate effectively with both technical and business staff
• Ability to triage incoming EDI issues through monitoring
• Strong analytical skills and attention to detail

Education Requirements

• Bachelor’s degree in Computer Science, Information Technology, or a related field

Education Requirements Credential Category

• Bachelor’s degree

Experience Requirements

• Significant practical experience in EDI transactions and mapping, particularly with HIPAA standards
• Prior experience in a similar role within healthcare or managed care settings

Why work in Raleigh, NC

Raleigh, NC, offers a rich blend of southern charm and modern amenities. With a strong technology and healthcare industry presence, Raleigh provides ample opportunities for career advancement. The city’s vibrant culture, scenic parks, and educational institutions make it an ideal location for both personal and professional growth.