Responsible for analyzing requirements, design, testing, and implementation of various Electronic Data Interchange (EDI) transactions. Performs day-to-day EDI process functions and operations related to contractual requirements, joint interface plan (JIP) specifications, and HIPAA EDI transaction processing requirements. Ensures deadlines are met and contributes technical expertise with EDI transaction processing framework. Works closely with Director of Information Systems (IS) and with various departments at El Paso First (EPF) for EDI interface development, maintenance, and troubleshooting. Assists with managing projects of various complexities, including implementation of HIPAA transaction sets and other JIP custom interfaces.
Required Skills
Required Experience
Work Experience Five years of experience in managed care applications of which three years should be working with SQL, creation of DTS packages, Stored Procedures, current Windows platforms, Visual Basic, Globalscape EFT, and Microsoft Access required. Healthcare maintenance organization (HMO) claim systems experience is required. Proven experience in processing Texas Medicaid Joint Interface plan files, use of Microsoft Biztalk, HIPAA transaction code sets, and other EDI batch processing automation tools. Must demonstrate above average proficiency with EDI interface engine tools to troubleshoot, develop, and process files, build datasets, and create managed care applications. Experience with evaluating technology.
License/Registration/Certification None.
Education and Training Bachelor degree in Information Systems or related field required. QNXT Data Schema, QNXT Connect, and QNXT EDI training required.