Troubleshoot EDI mapping issues and EDI error records.
Troubleshoot Encounter data reporting errors and monitor Encounter Data Quality reports.
Ensure adherence to EDI standards.
Write complex SQL queries and stored procedures; develop SSIS jobs for EDI file submission.
Develop and maintain EDI documentation including process flow.
Collaborate with cross-functional teams to identify EDI problem areas.
Prepare test data, conditions, and expected results to verify new EDI updates and logic.
Work with membership, provider, and claims data; apply strong SQL programming and EDI analytical skills.
Requirements
Bachelor’s degree in Information Systems, Computer Science, Database Management, or related field.
Minimum 5 years of programming experience in SQL Server database object development including but not limited to stored procedures, functions, views, SSIS and SSRS, X12 EDI mapping and development, and troubleshooting EDI errors.
Minimum 3 years’ experience in complex healthcare data like Claims and Enrollment.
Working knowledge of EDI X12 Standards.
Previous experience in BI reporting tools, such as BusinessObjects, Tableau, or Power BI.
Knowledge of Visual Studio, .Net Development, XML, BizTalk.
Need to have worked for Emblem health in the past.