Job Description :
Launch Your Career with Cook Systems
Ready to elevate your career? Cook Systems, a certified veteran owned IT consulting firm, has been transforming businesses and careers since 1990. Whether you're aiming to work with a Fortune 500 company or a small business, we've got you covered.
Our core values: integrity, investment, and innovation drive everything we do, ensuring you grow and succeed in a dynamic, supportive environment. We understand the importance of work life balance and personal growth. Our cutting edge IT consulting partners and FastTrack talent program are designed to help you excel.
Join our forward thinking team where excellence and creativity are valued every day. Check out what our associates have to say on Glassdoor. Ready to take your career to new heights? Cook Systems is where your journey to success begins!
The Indiana Department of Health (IDOH) is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS.
NOTE: Hourly rate based on experience.
Local candidates only. Candidate must be local to Indianapolis. Please provide current home address.
Selected resource will be required to work onsite 3 days per week and 2 days remote. Please confirm the resource understands this requirement.
The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers at IDOH, are loaded into our database, are adjudicated based on state and national pricing standards, and as adjudication messages are generated and sent back to the originating provider. This position will work with the project manager, software developers, business analysts, and functional team members on the project activities.
Essential Duties / Responsibilities:
- Review update all documentation related to claims processing and EDI transactions
- Identify incompletely documented claims processing and EDI processes, and document them
- Work with development team as a SME as IDOH?s ACAPS system is rewritten in .Net
- Act as liaison between OTC team and the Children?s program area on claims processing issues
- Working with technical and functional staff on detailed business requirements, understanding business processes and technology, agency standards, federal and state policies to align with project?s goals.
- Write technical specifications based on conceptual design and stated business requirements.
- Test new and existing systems
- Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.
- Provide helpdesk level support for EDI claim transactions.
o Provide support to healthcare providers who interact with IDOH?s CSHCS system
o Assist in onboarding new providers
o Assist in onboarding new clearinghouses
- Ability to work independently with less guidance and work with ISDH externals partners as needed.
REQUIRED SKILLS....
Bachelor?s Degree in Computer Science or related fields with IT experience
Required
Database knowledge
Required
5
Years
Understanding EDI file formats (835, 837, 210)
Required
5
Years
Knowledge of HIPAA regulations
Required
Ability to solve complex troubleshooting issues
Required
Excellent verbal and written communication skills
Required
Health Industry experience
Highly desired
Knowledge of IBM Websphere (WTX)
Highly desired
Database/SQL experience
Highly desired
Why Work with Us
Benefits
At Cook Systems, we don't just offer jobs we build futures. Our team is the heart of everything we do, and we're committed to supporting you with benefits that go beyond the basics. We want you to feel secure, valued, and empowered from the very beginning of your journey with us. When you join Cook Systems, here's what you can look forward to:
Your Health, Your Way: Choose from two comprehensive medical plans through Blue Cross Blue Shield, complete with dental and vision coverage. With access to one of the nation's largest networks, you'll get the care you need for yourself and your family wherever life takes you.
Peace of Mind, Every Step of the Way: Protect what matters most with life, critical illness, and accident insurance through Unum. Because your loved ones deserve security no matter what the future holds.
Flexibility for Life's Needs: Save money and plan ahead with a Flexible Spending Account and Daycare FSA through Navia, helping you manage healthcare and dependent care expenses on your terms.
Bridging the Gaps: Unexpected costs? No problem. Our Health Gap Insurance through Sunlife helps ensure you're covered when it counts.
Your Future Starts Now: Dream big with our 401(k) retirement plan through The Standard. After just six months, you will be eligible to participate, because your future deserves a strong foundation.
At Cook Systems, you're not just another employee you're family. Here, your ideas matter, your contributions shine, and your career will thrive. Together, we innovate, grow, and celebrate success every step of the way. Are you ready to be part of something bigger? Let's build the future together at Cook Systems.