EDI Business Specialist
Itero Group LLC

Job Info

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Itero Group is growing! We have a career opportunity for an EDI Business Specialist . The position will be a REMOTE opportunity based out of our New Cumberland office.

As a EDI Business Specialist, you're a core member of the Part A and B Fee for Service Maintainer Implementation and Operations teams specializing in EDI transactions and business processes to transform data for loading and extraction. The EDI Business Specialist will work with clients/vendors, business operations and product developers managing client and program-specific file configuration, mapping, testing and troubleshooting for all data exchange.
Responsibilities :

• Maintain expert knowledge of CMS and Encounter Data Submission requirements, guidelines and methodology
• Directly interface with clients/vendors to identify and document business requirements for data exchange
• Coordinate all data exchange/EDI activities with trading partners and gateway vendors
• Create functional/technical requirements sufficient to translate business requirements into documentation programmers can work from
• Perform the development or works with a developer to create product solutions
• Oversee the ETL process, working with clients/vendors to ensure comprehensive data extract and load processes
• Creates and maintains or oversees the creation and maintenance of all data maps, cross-walks, data transformation, and ensures timely and accurate data loads

Required:

• 3-5 years of experience with HIPAA/EDI X12 v5010 and HL7 healthcare-related file formats, including 837, 835, 276/277, 999, TA1 and Medicare Error Response files.
• E xperience developing EDI maps
• E xpert in scenario/script development expertise
• Proficient knowledge of health data code sets, such as ICD-10, CPT/HCPCS, Revenue Codes, etc.
• P roficient in regulatory requirements associated with HIPAA, CAQH CORE, Affordable Care Act; knowledge of Medicare requirements, preferred
• Knowledge of coding languages and methodologies (e.g. JAVA, SQL,) and proficiency in data management and analysis language is desired
• Proficient in requirement elicitation
• Experience working in an Agile customer focused environment

Preferred :

• You're able to develop user materials
• You have healthcare claims processing experience
• You know best practices development and business process improvement

Public Trust Security Clearance is required for this position.
US Citizenship/Green Card/Permanent Residency is required for this position.

Snapshot of Benefits:

• Health, Dental and Vision insurance
• 401K Plan with a company match
• Paid Time Off
• Paid Holidays
• Flexible Spending Account
• Student Loan Repayment Assistance
• Continuous Training
• Group Life, and Short- and Long-term Disability Insurance

Itero Group is an equal opportunity employer and does not discriminate against any employee or applicant because of race, age, sex, color, physical or mental disability, religion, sexual orientation, marital status, national origin, or political affiliation.

This job has expired.