Senior EDI Developer

Cook Systems • Indianapolis, IN

1d • Hybrid

About The Position

The EDI Expert plays a crucial role in managing the lifecycle of claims as they move from health providers to the Indiana Department of Health (IDOH) and through various stages of processing and adjudication. This position collaborates with project managers, software developers, business analysts, and functional team members to support effective project activities within IDOH.

Requirements

• Proven experience in EDI transactions and claims processing.
• Strong documentation and technical writing skills.
• Experience with .Net development and system rewrites.
• Excellent communication and liaison skills for working with various stakeholders.
• Ability to understand and align business processes with state and federal policies.
• Experience in testing systems and resolving data transmission conflicts.
• Ability to work independently and collaboratively with external partners.
• Customer support experience in healthcare provider onboarding.

Responsibilities

• Review and update all documentation related to claims processing and EDI transactions.
• Identify and document incomplete claims processing and EDI processes.
• Serve as a Subject Matter Expert (SME) for the development team as IDOH's ACAPS system is rewritten in .Net.
• Act as a liaison between the OTC team and the Children’s program area on claims processing issues.
• Collaborate with technical and functional staff to understand business requirements, processes, technology, and relevant policies.
• Write technical specifications based on conceptual designs and business requirements.
• Test new and existing systems to ensure functionality and accuracy.
• Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.
• Provide helpdesk level support for EDI claim transactions.
• Support healthcare providers interacting with IDOH’s CSHCS system, including onboarding new providers and clearinghouses.
• Work independently with minimal guidance and collaborate with ISDH external partners as needed.

Benefits

• Choose from two comprehensive medical plans through Blue Cross Blue Shield, with dental and vision coverage included.
• Protect what matters most with life, critical illness, and accident insurance through Unum
• Plan ahead and save with a Flexible Spending Account and Daycare FSA through Navia
• Our Health Gap Insurance through Sun Life helps cover unexpected costs
• Build your future with our 401(k) plan through The Standard. You’re eligible after just six months

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed