Project Specialist
Alpha Business Solutions
**
Philadelphia, Pennsylvania
Basic
Posted about 10 hours ago
Position: EDI Specialist
Location: Philadelphia, PA
Duration: 6+ Months
Job Description
Specific Duties/Requirements
· Requires an extensive knowledge of EDI Portal and managing inbound EDI enrollment file activity.
· Responsible for ensuring successful transfer of inbound EDI enrollment data to include troubleshooting/reconciliation of data integrity issues.
· Responsible for managing EDI file activity for high-profile/complex EDI client business (BPO, Shared Services, non-standard, etc.).
· Direct contact between EDI senders, clients, Account Management teams, Customer Experience teams, BizTalk/.Net teams, and project teams.
· Responsible 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 area.
· Responsible for providing support to the Department’s Business Systems Analyst with client specific EDI enrollment testing.
Additional Job Responsiblities
· Assist in the development of user system documentation and desk level procedures.
· Manage daily team inventory activity and provide support/training/direction to Eligibility Specialist team members.
· Support enrollment related issues resolution/Enrollment Resolver Group participant.
· Organize/disperse team project work to other team members.
· Assist with manual enrollment processing for all lines of business.
· Support Member Enrollment System platform (to include development work, inquiries and EDI file activity)
· Meet departmental quality and production standards
· Other duties as assigned by the Leadership Team.
Qualifications - External
Knowledge Summary
· Ability to work with multiple business systems and have a general understanding of system design.
· Knowledgeable of Microsoft office products and project management tools.
· Effective oral and written communications skills necessary.
· Must have a general understanding the business environment and associated systems.
· Must be detail oriented and have a general understanding of corporate business systems.
· Must be able to work independently with assigned task.
· Ability to investigate, perform preliminary testing and present findings.
· Technical writing skills needed.
· Must 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 space
· Understanding of XML/ANSI 834 / HIPAA X12 transactions would be beneficial.
· In lieu of degree, minimum 2- 3 years proven EDI/eligibility experience
· Strong communication and analytical skills required.
Scope:
· Has working knowledge and experience in own discipline.
· Continues to build knowledge of the organization, processes and customers.
· Performs a range of mainly straightforward assignments.
· Uses prescribed guidelines or policies to analyze and resolve problems.
· Receives a moderate level of guidance and direction from more senior level roles.
Benefits:
We offer a competitive compensation package that includes:
· [Pay Rate]: $35 per hour W2
o Note: Pay rate will be commensurate with experience.
· Medical for full time employees
· Dental, and Vision Insurance
· Life Insurance, Short-Term Disability, Long-Term Disability, etc.
Location: Philadelphia, PA
Duration: 6+ Months
Job Description
Specific Duties/Requirements
· Requires an extensive knowledge of EDI Portal and managing inbound EDI enrollment file activity.
· Responsible for ensuring successful transfer of inbound EDI enrollment data to include troubleshooting/reconciliation of data integrity issues.
· Responsible for managing EDI file activity for high-profile/complex EDI client business (BPO, Shared Services, non-standard, etc.).
· Direct contact between EDI senders, clients, Account Management teams, Customer Experience teams, BizTalk/.Net teams, and project teams.
· Responsible 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 area.
· Responsible for providing support to the Department’s Business Systems Analyst with client specific EDI enrollment testing.
Additional Job Responsiblities
· Assist in the development of user system documentation and desk level procedures.
· Manage daily team inventory activity and provide support/training/direction to Eligibility Specialist team members.
· Support enrollment related issues resolution/Enrollment Resolver Group participant.
· Organize/disperse team project work to other team members.
· Assist with manual enrollment processing for all lines of business.
· Support Member Enrollment System platform (to include development work, inquiries and EDI file activity)
· Meet departmental quality and production standards
· Other duties as assigned by the Leadership Team.
Qualifications - External
Knowledge Summary
· Ability to work with multiple business systems and have a general understanding of system design.
· Knowledgeable of Microsoft office products and project management tools.
· Effective oral and written communications skills necessary.
· Must have a general understanding the business environment and associated systems.
· Must be detail oriented and have a general understanding of corporate business systems.
· Must be able to work independently with assigned task.
· Ability to investigate, perform preliminary testing and present findings.
· Technical writing skills needed.
· Must 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 space
· Understanding of XML/ANSI 834 / HIPAA X12 transactions would be beneficial.
· In lieu of degree, minimum 2- 3 years proven EDI/eligibility experience
· Strong communication and analytical skills required.
Scope:
· Has working knowledge and experience in own discipline.
· Continues to build knowledge of the organization, processes and customers.
· Performs a range of mainly straightforward assignments.
· Uses prescribed guidelines or policies to analyze and resolve problems.
· Receives a moderate level of guidance and direction from more senior level roles.
Benefits:
We offer a competitive compensation package that includes:
· [Pay Rate]: $35 per hour W2
o Note: Pay rate will be commensurate with experience.
· Medical for full time employees
· Dental, and Vision Insurance
· Life Insurance, Short-Term Disability, Long-Term Disability, etc.