Information Technology

Employment TYPE



Raleigh, North Carolina


February 19, 2021


Information Technology





Job# J1189

IT Lead EDI Specialist

About The Opportunity

NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project.

Job Description

  • NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform Project.
  • This position is responsible for the following activities related to a critical system being developed in-house at the State:
  • High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
  • Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
  • Develop and execute test scripts related to X12 Transmission. Conducts QA and Testing on EDI applications. Develop and execute Test scripts related to X12 Transmission. Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing
  • Provides technical support during and after implementation for healthcare electronic data interchange applications
  • Responds to inquiries regarding EDI issues with encounter claims and trading partner activities
  • Management of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
  • Communication between Trading Partners and department
  • Maintain detailed documentation and process flow of all EDI processes
  • Identify and facilitate issues with partner data mapping from onset through completion
  • Process and monitor all inbound and outbound X12 transactions
  • Support Customer Service group with EDI related issues
  • Identifies, recommends and implements process improvements in support of the EDI system
  • Troubleshoot EDI document processing errors and work with trading partners directly to resolve in a timely matter
  • Conducts analysis of EDI transactions and is responsible for documentation and reports
  • Collaborate with EDI partners to resolve transmission problems.
  • Track day-to-day EDI & batch processes to identify and address problems as they arise reporting levels of activity using key established metrics for senior management
  • Effectively communicate issues and needs with internal business partners, external vendors, and healthcare providers
  • Develops and maintains cross walking and validation rules for file exchanges
  • Triages incoming EDI issues thru monitoring
  • Ability to communicate effectively with technical and business staff
  • Support internal resources to resolve issues, answer questions, and retransmit EDI documents when necessary
  • Work with end users to ensure user acceptance testing is thorough and complete
  • Employees should be able to work independently with minimal supervision.
  • Knowledge of Agile Methodology

Required Skills


12 Months

Please Contact me to discuss the hiring process!

Vomsi Kumar

Sr. Executive Recruiter
Contact: (310) 929-8421 Ext: 103

Hi! My name is Vomsi Kumar. Helping consultants with getting their desired job is what makes me feel alive. I build a unique relationship with each of my consultants and work on their profile as per their needs. I believe that my consultants are my assets and this motivates me to serve them in an even better manner. Hence, I work towards the success of every consultant I work with.