Job Description
Responsible for implementing tactics to achieve Electronic Data Interchange (EDI) strategies by working with multiple business areas and other IT professionals to document requirements, develop, test and implement electronic transactions with business partners. Support ongoing maintenance of these transactions and troubleshoot and resolve issues that arise. Maintain and support electronic transactions and/or applications by possessing knowledge of the organization's systems, business processes, as well as current technology advances and IT capabilities. Responsible for building and maintaining relationships with payer and clearinghouses/submitters. Responsible for researching claims discrepancy issues and producing claims reconciliation reports between clearing houses/submitters and Wellmark technology systems.
Qualifications
Required :
Additional Information
** Job Responsibilities**
a. Ensure EDI implementation projects are analyzed, planned, developed, compliant, tested and completed.
b. Create test transactions, run tests, find errors and confirm business requirements are met. Capture testing results in a test plan that compares expected to actual results.
c. Participate in industry workgroups to help define the implementation of ANSI X12 transactions and ensure Wellmark’s compliance with the HIPAA X12 guidelines.
d. Support and adhere to Wellmark’s software development lifecycle (SDLC), operational and development procedures, and security standards.
e. Assist other Technology EDI staff in determining best practices for business process improvement to positively impact level of service.
f. Collaborate with EDI team and Electronic Commerce (EC) Solutions to understand and set direction for EDI transactions.
g. Manage the day-to-day EDI relationships between Wellmark and submitters.
h. Provide assistance to project managers in project administrative tasks, including project reporting and documentation.
i. Identify and report deliverable status and/or issues to project manager and leader. Communicate accurately and concisely in a forum appropriate to the audience.
j. Establish and build working relationships with IT and business teams. Actively listen to others’ ideas; share information and ideas to help team reach goals.
k. Provide exceptional service for our stakeholders ensuring timely and accurate results.
l. May organize EDI marketing efforts with submitters.
m. Other duties as assigned.
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us atcareers@wellmark.com
Please inform us if you meet the definition of a "Covered DoD official".
At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources: Nonimmigrant Workers and Green Card for Employment-Based Immigrants
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