Medicaid EDI Manager

Title: Medicaid EDI Manager
Location: Mason OH - Hybrid: 3x a week.
Duration:0-10 month(s)

Job Description:
The Medicaid EDI Manager will play a critical role within the Business Data Solutions team to maintain and implement Medicaid encounter feeds.
The Medicaid Manager will be the primary resource implementing new client and/or state outbound transactions.
The Manager will develop requirements based on stakeholder meetings and interpretation of Companion Guides.
The Manager will identify, recommend and implement process improvements in support of the EDI system based on observation, monitoring and external inquiries regarding EDI issues.

Secondary responsibilities include researching and analyzing encounter edits or rejections for Medicaid clients and work with internal/external teams to resolve.
The Manager will work to improve overall encounter, member and provider data quality.
As well they will track encounter submission quality and timeliness.

Specific Skills Needed:
Top 3-5 mandatory and/or minimum requirements Ability to analyze claims data Develop standard and custom testing plans to ensure compliance with requirements Maintain detailed documentation and process flow of all EDI processes

Top 3-5 desirable attributes/qualifications? HIPAA X12 EDI Transactions experience Experience with EDI mapping for 837, 999, 277CA, 835 Experience with Medicaid Claims processing