Job Description :
EDI Specialist (Electronic Data Interchange)
Rensselaer, NY
24 Months
Job Description:
NYSOH is New York''s official health plan marketplace established by Executive Order No. 42. Development and design of the marketplace is funded with federal Exchange establishment grant funds. The temporary personnel services requested are needed to support the on-going design and development of information technology systems consistent with enrollment goals and federal and state law and rules, as well as support for and participation in the operations and maintenance of the systems.
The Specialist (expert) will have responsibility for the technical operational aspects of the New York Health Benefit Exchange (NY-HX This includes all software and technical infrastructure in support of the design, development and implementation of NY-HX systems. Specific duties include:
Lead analysis, processing, metrics and reporting of Electronic Data Interchange (EDI) transactions
834 EDI subject matter expert
Builds and manages detailed test plans from business and technical requirements for all components of the systems, including but not limited to EDI/834 transactions, eligibility and enrollment for the Marketplace.
Evaluates testing and confirm that results are consistent with the system or business processes;
Lead technician for reconciliation efforts, processing, validating and analyzing large quantities of data that is exchanged between the Marketplace and all engaged trading partners.
Analyzes and revises flow charts, process models and technical specs describing as-is or to-be IT systems or business processes.
Candidates should have at least 84 months experience and a majority of the following should apply:
Each candidate should fill out the months of experience they have for each item in the table:
1. 84 months of experience with 834 Electronic Data Interchange (EDI) transactions, including mapping 834 ANSI X12 files to XML format, validating Acknowledgements and Rejections, and verifying data recorded on Enrollment 834 files. #OF MONTHS 20
2. 84 months of experience in System Integration Testing (SIT) and User Acceptance Testing (UAT), including preparing test cases from technical requirements and designing test scripts for various environments. #OF MONTHS 16
3. 84 months of experience analyzing, developing and revising flow charts, process models and technical specifications describing as-is or to-be Information Technology (IT) systems or business processes. #OF MONTHS 16
. 84 months of experience with TR3 and Companion Guides. #OF MONTHS 9
5. 48 months of experience reconciling 834 transactions/enrollment coverage for various plans. #OF MONTHS 6
6. 48 months of experience with Rational Team Concert (RTC), including logging, tracking, and prioritizing work items. #OF MONTHS 6
7. 48 months working with Health Insurance or the Affordable Care Act or Medicaid which includes Eligibility and Enrollment (not Health Care #OF MONTHS 6
8. Bachelor’s Degree in Information Technology or Computer Science or similar field of study. #OF MONTHS 1