Encounter Data Engineer (EDI, Managed Care)

Scope of Role & Responsibilities

• Monitor and submit Encounter Data files to NYSDOH OSDS and CMS.
• Collaborate with vendors/end users on correcting EDI error transactions and resubmissions to NYSDOH and CMS.
• Automate manual processes for Encounter Data submissions.
• Support the Compliance and Regulatory department for any inquiry on Encounter Data processes.
• Support MMCOR reporting
• Create KPI reports on Encounter Data reporting.
• Create SQL stored procedures and flow diagrams and document the process for Encounter Data Reporting.
• Troubleshoot EDI Errors and keep track of all the resubmissions.

Required Education, Training & Professional Experience

• Bachelor’s degree in Information Systems, Computer Science, Database Management, or related field.
• Minimum 5 years of programming experience in SQL Server database object development including but not limited to stored procedures, functions, views, SSIS and SSRS, X12 EDI mapping and development, and troubleshooting EDI errors.
• Minimum 3 years’ experience in complex healthcare data like Claims and Enrollment.
• Working knowledge of EDI X12 Standards
• Previous experience in BI reporting tools, such as BusinessObjects, Tableau, or Power BI
• Knowledge of Visual Studio, .Net Development, XML, BizTalk.

Professional Competencies

• Integrity and Trust
• Collaboration and Time management skills
• Functional/Technical skills
• Written/Oral Communication
• Ability to work effectively in a team environment and adapt to different projects and assignments quickly.
• Excellent analytical and problem-solving skills

Pay

$125,000.00 - $130,000.00

Schedule

Regular

Benefits

Not specified