Summary: The EDI Implementation Specialist is responsible for the analysis, design, development, implementation and support of the EDI related components of the organization. Reporting to the Sr. Director of IT and Operations, this technical focused individual will require a strong understanding of the interaction between the CTS systems and customers systems, from a submitter and receiver perspective. The role focuses on moderate to complex implementation tasks and responsibilities.
The EDI Implementation Specialists’ is responsible for assessing, analyzing, and implementing solutions in a timely and efficient manner. Key responsibilities include, but are not limited to a) managing internal and external relationships with partners, providers, and vendors to meet integration objectives; b) creating appropriate documented deliverables, managing deliverables, gaining agreement from internal and external partners; and c) coordinating partner awareness on CTS functionality as requested by Product Management and production issues as requested by internal teams, including but not limited to Operations support team and/or Information Technology team.
Essential Duties and Responsibilities include the following:
- Analyze, design, develop, test, troubleshoot, optimize, enhance and maintain EDI applications in various formats including HIPAA standard formats such as 837 and 834.
- Responsible for the implementation of any new customer relationship using Electronic Data Interchange.
- Manage receipt and delivery of test files; advise management of any issues with adjudication system test files. Work with the Project Manager and client if there are any issues with client test files
- Evaluate requests for new and modifications to applications/programs/processes/maps.
- Maintain detailed documentation of implementation customizations, routing rules and process flow of all EDI processes.
- Participate in project meetings, providing input to project plans and providing status updates on assigned tasks.
- At the request of end users or management, research questions involving EDI applications and how the data is organized and populated.
- Assist with any and all production EDI issues.
Non-Essential Duties and Responsibilities: include the following:
No non-essential duties and responsibilities have been assigned.
No supervisory responsibilities
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This position requires a person with a high energy level, comfortable performing multifaceted projects in conjunction with day-to-day activities. In addition, the following skills are required:
- Strong communication skills (verbal and written)
- Sound judgment and reasoning
- Solution oriented with strong problem-solving skills
- Superior work flow management
- Well-organized and strong multitasking skills
- Good interpersonal skills and works well in a team environment
- Proactive in nature – ability to foresee potential issues on project and raise those concerns to the appropriate parties
Education and/or Experience:
- Bachelor’s degree (BA/BS) in Computer Science or related field of study preferred.
- 3+ years of experience in the designing, deploying, monitoring, configuring and troubleshooting of enterprise solutions in a health care environment.
- Must have recent experience with HIPAA EDI transactions including: EDI X12 270, 271, 276, 277, 278, 820, 834, 835, 837.
- Experience with different file formats (fixed length, delimited, XML and EDI 837) required.
- Familiar with common types of connectivity solutions (FTP/Secure FTP, Webfolders (WebDAV), VPN).
- Must have strong functional spec and technical documentation skills.
- Project management experience a plus.
- Analysis and design skills of varied complexities.
Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.
The ability to understand more advanced computer skills and be proficient in the intermediate knowledge of software such as Microsoft Word, Excel and Access.
Scope of Responsibilities:
Incumbent functions independently within broad scope of established departmental policies and goals, generally refers specific problems to supervisor only where clarification of operations policies and procedures may be required.
Internal and external relationships stretch across broad organizational lines or involve a high degree of technical understanding and the ability to communicate technical concepts. The incumbent must proceed in relationships where innovative and unstructured situations arise.
Certificates, Licenses, Registrations:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, depth perception and ability to adjust focus.
Note: Regularly – more than 2/3 of the time, Frequently – 1/3 to 2/3 of the time, Occasionally – less than 1/3 of the time
Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.