Job Description :
EDI Programmer/Analysts | Baltimore MD
Duration: 6+ Months

Job Description:
Major Duties and Responsibilities:
Primary development role related to the eligibility and claims adjudication system and internal processes.
Responsible for importing data feeds into Oracle database or exporting data from the database into appropriate EDI formats to support member ‘eligibility’ and ‘encounter’ business processes
Responsible for developing and testing HIPAA EDI 5010 X12 mapping formats (834,837,277,999) as well as industry standard and custom formats using ETL tools
Review, evaluate, design and implement systems processes to ensure data integrity is consistently maintained.
Coordinate with external clients and internal operations depts. to ensure effectual setup and design of data formatting and flow for new client implementations.
Own and project manage the development of ongoing implementations start to finish from client meeting and companion guide, through internal testing process and development and into production with documentation.
Provides ad-hoc data/reports to clients or internal departments per request.
Produce comprehensive documentation of all developed software & repositories.
Automation of routine processes with appropriate monitoring controls.
Other duties as assigned.
Education:
Bachelor’s Degree in Computer Science or related field.
Experience:
Minimum of 5 years relevant work experience and experience in managed health care is helpful.
Competencies:
Prior experience in EDI Programmer/Analyst role.
Accuracy, attention to details.
SQL Server database (2012
SQL Server Integration Services (SSIS
SQL Server Reporting Services (SSRS
Experience in implementation of control and reconciliation reports.
Advanced knowledge and understanding of relational database environments.
Previous experience in a health-care claims adjudication system.
Experience developing encounter and eligibility transactions set maps and processes in HIPAA EDI5010 X12.
Experience writing PL/SQL queries in Oracle or SQL Server.
Experience with an ETL and data mapping tools.
Experience in structured, data-driven, functional logic programming.
Team oriented with the ability to work effectively across functional areas of the company.
Excellent analytical, problem resolution and people skills.
Ability to deliver quality results under tight deadlines.
Excellent customer service orientation.
Ability to work independently with moderate supervision.
Understanding of health care insurance data is a plus


Client : multiple

             

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