EDI Specialist

3 weeks ago

Manila, National Capital Region, Philippines Private Advertiser Full time

Roles and Reponsibilities:

Responsible for ensuring successful transfer of inbound EDI enrollment data to include troubleshooting/reconciliation of data integrity issuesResponsible for managing EDI file activity for high-profile/complex EDI client businessDirect contact between EDI senders, clients, Account Management teams, Customer Experience teams, BizTalk/.Net teams, and project teamsResponsible for supporting project work within the business area (lead and/or participate in project meetings, sprint work, business requirement documentation, system upgrades, and business check-outs)Responsible for managing all robotic process automation (RPA) work for the business areaResponsible for providing support to the Department's Business Systems Analyst with client specific EDI enrollment testingMeet departmental quality and production standards

Additional Job Responsibilities as Needed

Assist in the development of user system documentation and desk level proceduresAssist with manual enrollment processing for all lines of businessSupport Member Enrollment System platform (to include development work, inquiries, and EDI file activity)Other duties as assigned by the Leadership TeamKnowledge SummaryRequires extensive knowledge in EDI Portal and managing inbound EDI enrollment file activityAbility to work with multiple business systems and have a general understanding of system designKnowledgeable in MicrosoftOoffice products and project management toolsEffective oral and written communications skills necessaryMust have a general understanding the business environment and associated systemsMust be detail oriented and have a general understanding of corporate business systemsMust be able to work independently with assigned taskAbility to investigate, perform preliminary testing and present findingsMust have related enrollment experience in the Health Rules system platform, a full understanding of the Front Office System and how these platforms interact with EDI Portal for EDI enrollment validation

Education & Experience

Bachelor's degree in business administration, Management Information Systems, Computer Science, or equivalent work experience in the Healthcare/Technology spaceIn lieu of degree, minimum 2- 3 years proven EDI/eligibility experienceStrong communication and analytical skills required

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