EDI with HIPAA Expert

Description

Message Broker development experience. Edifecs Development. EDI Transaction experience (HIPAA Preferred) Knowledgeable of balancing required with an 837 HIPAA transaction Knowledgeable in 4010A1 and 5010 HIPAA implementation guides relate tClaim receipt and forwarding processes Can write code in accordance with documented regulator changes found when moving from 4010A1 t5010 All coding will be stored in predefined directories in a company provided implementation development environment Will utilize test cases/scripts generated for each requirement tinclude a physical record tbench test their developed or modified code Must understand when tuse an EOB vs. an EOP vs. an 837 Should be familiar with Clearinghouse processes and replies (997 and/or 999) Technical knowledge would include but not be limited tProgramming Language XML, MQ, Message Broker and Stored Procedures Software IDE(s) Used are SpecBuilder, Data Stage, Crystal Database access via SQL for SQL Server 2005 Application Server utilizes XEngine, Transaction Manager (TM), Mapper (Translator), InfoServer Must understand and be able tconduct Claim Remittance testing Should be familiar with claims related t837 Professional, 837 Institutional and 837 Dental FEP, Medicaid, Medicare, Medigap and NASCKnowledgeable of balancing required with an 837 HIPAA transaction Knowledgeable in 4010A1 and 5010 HIPAA implementation guides relate tClaim receipt and forwarding processes Can write code in accordance with documented regulator changes found when moving from 4010A1 t5010 All coding will be stored in predefined directories in a company provided implementation development environment Will utilize test cases/scripts generated for each requirement tinclude a physical record tbench test their developed or modified code Must understand when tuse an EOB vs. an EOP vs. an 837 Should be familiar with Clearinghouse processes and replies (997 and/or 999) Technical knowledge would include but not be limited tProgramming Language XML, MQ, Message Broker and Stored Procedures Software IDE(s) Used are SpecBuilder, Data Stage, Crystal Database access via SQL for SQL Server 2005 Application Server utilizes XEngine, Transaction Manager (TM), Mapper (Translator), InfoServer Must understand and be able tconduct Claim Remittance testing Should be familiar with claims related t837 Professional, 837 Institutional and 837 Dental FEP, Medicaid, Medicare, Medigap and NASCMust have excellent hands on skills with MS Office suite (Word, Excel, PowerPoint, Visio) Summary Analyzes requirements, designs and writes software applications by performing the following duties. Essential Duties and Responsibilities Consults with clients and Solutions Center Managers tgather information about program needs, objectives, functions, features, and input and output requirements. Analyzes, defines and documents requirements for data, workflow, logical processes, hardware and operating system environment, interfaces with other systems, internal and external checks and controls, and outputs. Writes and maintains technical specifications. Develops and maintains plans outlining steps and timetables for developing programs. Researches and evaluates software and hardware tassist in programming or tuse as program platforms. Designs and codes screen layouts, graphical user interfaces, printed outputs, and interfaces with other systems.