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Sr. EDI Engineer
Location:
US-CA-Brea
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Sr. EDI Engineer (Brea, CA – Telecommuting permissible) (multiple positions). Perform all key aspects of Electronic Data Interchange (EDI), Provider Payments, Eligibility and Encounters management, as well as operate as the Subject Matter Expert (SME) and technical resource for internal stakeholders regarding Claims IT solutions, including production issues. Design, develop, and support IT applications related to EDI, Provider Payments, Eligibility and Encounters for new and existing clients. Manage projects and documentation, as well as Quality Assurance and Implementation support. Conduct analysis and resolve issues related to Payments, Encounters, Authorization, Eligibility Reporting in EDI standards. Provide solutions to improve operational efficiency in health care IT Claims between our internal infrastructures and Network Partners, Payers, and fellow NCH colleagues. Requires a Master’s degree or foreign equivalent in Computer Science, Computer Information Systems, Computer Engineering, or related field, and two (2) years work experience in the job offered or in a position within the healthcare industry performing the design and development of EDI and Encounters Systems. Must have two (2) years of experience in the healthcare industry in each: 1) Designing and developing interfaces related to Encounter and Payment management and integration; 2) Developing EDI solutions and reports using Microsoft SSIS, SSRS, SQL, and .NET scripting; 3) Implementing HIPAA EDI X12 transactions for Claims, Authorizations, ERA EFT Payment, and Eligibility using standard X12 parsing and SNIP level validation tool Claredi; 4) Designing and developing EDI data management workflow automation using Microsoft C#.Net, VB.Net components, Azure Repository, and Team Foundation Server; and 5) Conducting data quality analysis of large datasets of Claims, Authorizations, Member, and Provider information. Send resume with cover letter to NCH Management Systems Inc. dba New Century Health, Ref MR2022, HumanResources@evolenthealth.com. No calls. EOE

Ref MR2022
NCH Management Systems Inc dba New Century Health
Brea, CA

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