Required Skills

EDI

Work Authorization

  • US Citizen

  • Green Card

  • EAD (OPT/CPT/GC/H4)

  • H1B Work Permit

Preferred Employment

  • Corp-Corp

  • W2-Permanent

  • W2-Contract

  • Contract to Hire

Employment Type

  • Consulting/Contract

education qualification

  • UG :- - Not Required

  • PG :- - Not Required

Other Information

  • No of position :- ( 1 )

  • Post :- 23rd Sep 2024

JOB DETAIL

  1. Develop, implement, and maintain EDI solutions that support healthcare-related transactions.
  2. Work with stakeholders to map and define EDI processes in accordance with business needs.
  3. Ensure the successful processing of healthcare EDI transactions including but not limited to:
  • 834: Benefit Enrollment and Maintenance
  • 837: Health Care Claims (Professional, Institutional, and Dental)
  • 270/271: Eligibility, Coverage, or Benefit Inquiry and Response
  • 276/277: Health Care Claim Status Request and Response
  • 835: Health Care Claim Payment/Remittance Advice
  • 820: Health Insurance Premium Payment
  • 275: Patient Information
  • 278: Health Care Services Review
  1. Collaborate internal teams to resolve transaction issues and ensure data accuracy.
  2. Conduct regular testing, validation, and troubleshooting of EDI systems to meet regulatory and operational requirements.
  3. Monitor transaction activity to ensure the integrity of EDI processing.
  4. Prepare and maintain technical documentation for all processes and system integrations.
  5. Ensure compliance with HIPAA standards and other regulatory guidelines.
  6. Participate in system upgrades, migration, and EDI enhancements.

Company Information