Hi,

Please check and let me know

Kindly Mail me at: *abhis...@apetan.com* <abhis...@apetan.com>

*EDI Analyst*

*Rate: $**43*

*Mode:  Phone and Skype*

*Location:* *Linthicum MD*

*Duration:3+*



*Customer in MD looking for an EDI Analyst to work onsite for 3 months
plus. This is NOT a Business Analyst position so please read the
requirement well. Need to have Healthcare EDI experience with Programmer
Analyst background, able to do mapping and strong SQL skills. Must have
Previous experience in a healthcare claims adjudication system *





Primary job responsibility is to assume responsibilities for the
development and internal processes related to the eligibility and claims
adjudication system's file processing.

*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.

*Qualifications: *
*Education: *Bachelor's Degree in Computer Science or related field.
*Experience: *Minimum of 3-5 years relevant work experience and experience
in managed health care
*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.

 *Must have* Previous experience in a healthcare claims adjudication system
and strong healthcare background
Experience developing encounter and eligibility transactions set maps and
processes in HIPAA EDI 5010 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 vision care insurance or health care insurance data is a
plus.




*Remarks*:

Contract Position based onsite in Linthicum MD - expect 3 months plus
possible extension
Consultant MUST work onsite in MD office

Consultant MUST have:
- Healthcare Background
- Claims Processing/Adjudication background - i.e. must be on their resume
- EDI experience





 Thanks

Abhishek

abhis...@apetan.com

Apetan Consulting LLC

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