Under the direction of the EDI Technical Manager, the EDI Developer III designs, developments and implements all enhancements and new systems as well as oversees analysis and reporting related to Claims, Encounters, Eligibility, Pharmacy and other EDI systems and processes.
Required position will report to IT Supervisor or Manager. An EDI Developer III is expected to mentor other members of the team on development standards, best practices, quality and deliverable timeliness.
Major Functions (Duties and Responsibilities)
Design and development of solutions related EDI processes.
Collaborate with other departments and data stewards to assess and prioritize needs, and assist with developing strategies, plans, policies and procedures related to providing effective EDI solutions.
Design and implement effective solutions by utilizing best practice approach, making sure that new code is source saved and reviewed prior to implementation.
Participating in interviews, surveys, brainstorming sessions, storyboarding, prototyping, and use cases.
Mentor other members of the team on data quality, data completeness, data accuracy, and deliverable timeliness are built into every reporting solution
Manage and prioritize user requirements to help manage overall project scope
Discover, explore, analyze and document data from all source and target systems to better understand the total scope of data availability
Design, develop and implement processes and systems related to Encounters and other EDI processes.
Identify and communicate issues and risks to management in a timely manner
Gathers, analyzes requirements and develop processes and reports to meet business requirements
Experience Qualifications
Six (6) or more years in systems design, development and implementation of complex data driven processes.
Experience in report writing and analysis.
Experience in database design, query development, table joins and report development and creation.
Strong development experience and database capabilities.
Knowledge Requirement
Knowledge of EDI standards. Working knowledge of diagnosis and procedure coding, medical terminology, knowledge of managed care, claims payment processes, and insurance terminology preferred.
Skills Requirement
Strong expertise in Microsoft SQL Server, .Net, Database design.