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IN-IDOH Senior EDI Developer

indianapolis, in • Posted 1 weeks ago
Onsite Full Time General

EDI Expert PositionThe Indiana Department of Health (IDOH) is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers at IDOH, are loaded into our database, are adjudicated based on state and national pricing standards, and as adjudication messages are generated and sent back to the originating provider. This position will work with the project manager, software developers, business analysts, and functional team members on the project activities.Essential Duties / Responsibilities:Review and update all documentation related to claims processing and EDI transactionsIdentify and document incompletely documented claims processing and EDI processesWork with development team as a subject matter expert as IDOH's ACAPS system is rewritten in .NetAct as liaison between OTC team and the Children's program area on claims processing issuesWork with technical and functional staff on detailed business requirements, understanding business processes and technology, agency standards, federal and state policies to align with project's goalsWrite technical specifications based on conceptual design and stated business requirementsTest new and existing systemsEnsure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflictsProvide helpdesk level support for EDI claim transactionsProvide support to healthcare providers who interact with IDOH's CSHCS systemAssist in onboarding new providersAssist in onboarding new clearinghousesAbility to work independently with less guidance and work with ISDH external partners as needed

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