EDI Systems Specialist

nashville, Tennessee

A leading healthcare company is seeking a strong EDI Systems Specialist.

Responsibilities

  • Work on Medicaid related projects, tasks, and enhancements
  • Research and resolve Medicaid production Issues
  • Create and maintain incident and change requests
  • Help resolve data, data validation and translation issues
  • Ensure all Medicaid data exchanges are received/sent and processed
  • Perform daily reconciliation of all Medicaid data exchanges, identify exceptions and any variances with explanation
  • Research and respond to all questions related to Medicaid data exchanges

Qualifications

  • The candidate must have 5-7 years working experience in Healthcare EDI
  • Must be familiar with all the X12 transactional sets related to healthcare
  • Must be familiar with SSMS and create and run basic SQL queries
  • Must be reliable and be on call for Medicaid data exchange issues
  • Regulatory Management (HIPAA, CAQH/CORE, ACA, AS3, State/Federal mandates, etc.)
  • Understanding of HIPAA X12 Transactional Implementation Guides

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