EDI Manager

Position Title: EDI Manager

Location: Richmond, VA

 

**Only Qualified Candidates Will Be Contacted**

 

Our client is an HMO, IPA model, which began operations as a full service Medicaid HMO.

 

Our client was formed for the sole purpose of effectively coordinating health care for low-income persons. Our client currently services approximately 110,000 members.  Our client operates in over eighty counties in Central, Eastern, Western and Southwestern Virginia.

 

POSITION OVERVIEW

The EDI Manager is responsible for the daily supervision and support of the EDI Unit and all associated electronic development projects.

 

POSITION DUTIES AND RESPONSIBILITIESSupervise and manage the EDI Staff membersAnalyze Trading Partner Fatal Errors to determine if improvements can be madeDevelop EDI initiatives to implement Best Practices and improve overall EDI efficiencyServe as EDI expert to ensure compliance with HIPAA standardsImplement new EDI connections and provide analysis on existing connections in order to improve overall EDI percentagesBuild and maintain positive working relationships with internal and external customers to include Trading Partners, Providers, Hospitals and Billing CompaniesResponsible for recommendations and selection of technological solutions and software to improve and/or maintain business standardsMaintain ongoing documentation to include training, trading partner specifications, website documentation and policies & proceduresEnsure that all vendors are loaded into IDX within accepted time framesResponsible for all aspects of encounter reporting, which includes working with encounter specifications based on state requirements, working with sub-contractors, and providing resolution to encounter edits to ensure that all encounters are acceptedProvide ongoing analysis and reporting to track production and quality outcomes

 

 

REQUIREMENTS / SKILLSBA/BS Computer Science, IT or equivalentExperience with communication protocols such as FTP, HTTP, TCP/IP, etc.Background in ANSI X12 formats such as 835s and 837s.Strong leadership skills, excellent verbal and written communication skills beneficial

 

Qualified Candidates, please email your resume to Jim Dooley, jim@theheadhunter.com , with 2720-JLD-VA-M in the subject line.