The EDI Developer will work with MTM clients to ensure timely and accurate EDI onboarding (for new clients) and ongoing production support of EDI file transmissions, while continuously improving the department EDI processes and systems, resulting in the highest value possible for MTM customers. The position will be responsible for developing, testing, and implementing EDI processes and will function as EDI development expert assisting and training other EDI team members. The EDI Developer will maintain and operate the EDI systems, implement encounter, eligibility, other EDI transactions and related reports, analyze and research EDI issues, perform other EDI requests, projects, and tasks. The EDI Developer will perform within department policies and procedures, regulatory, contractual timeframes and guidelines, and management direction.
What You’ll Do:
Analyze, design, develop, test, troubleshoot, optimize, enhance and maintain EDI applications in various formats that include HIPAA standard formats such as 834, 835, 837, 277 and other proprietary formats using EDI mapping tools
Create and maintain interfaces between applications systems and EDI transactions
Maintain detailed documentation and process flow of all EDI processes
Apply in-depth knowledge of systems and business to the development of technical design for large complex processes and projects
Evaluate user requests for new and modifications to EDI applications/programs/processes/maps
Conduct research and make recommendations on products, services, protocols, and standards in support of EDI processing and data transfer efforts
Participate in project meetings, providing input to project plans and providing status updates
At the request of end users or management, research questions involving EDI applications and how the data is organized and populated
Provide status updates on all assigned tasks
Follow existing source code management and version control processes for all coding efforts
Perform maintenance and enhancements to the EDI system and database
Perform technical analysis and data mining for EDI reporting requests from internal and external customers
Support internal and external integration channels to the EDI system to ensure data interchange meets technical expectations and criteria
Ensure the validity of EDI transactions and accuracy of EDI reporting via technical quality control measurements and practices
Manage and ensure quality and consistent delivery for EDI transactions
In collaboration with others, develop and maintain databases necessary for projects and department functions
Acquire and abstract primary or secondary data from existing internal or external data sources
In collaboration with others, interpret EDI data and develop recommendations based on findings
Generate routine and ad hoc reports
Assist in managing Client expectations and project planning/implementations
Develop detailed source to target mapping from client data to our EDI specifications as well as data transformation documentation and explain the mapping to team members
Develop strategies and standards to improve the customer onboarding process and experience
Query data, compile data analysis, trends, error analysis and other information to assist clients to improve their EDI transactions
Act as the liaison between Business partners, clients, and IT
Manages work plans and timeliness
Ability to work with local and remote staff and consulting partners
What You’ll need:
High School Diploma or G.E.D equivalent
Bachelor's degree or 4+ years of EDI Development experience
3 - 5 years’ experience in EDI development, tools and HIPAA/X12 standards
3 – 5 years’ experience with Relational databases, such as Microsoft SQL Server
Exposure and general understanding of Healthcare claims processing
Ability to write SQL queries to extract data from databases/ODS
Even better if you have...
2 years of experience in health care industry, preferred
Preferred experience in Agile, MS SharePoint, Project Management
Development experience with 834, 835, 837, 277 and other standard EDI transactions
Clear understanding & working knowledge of HIPAA EDI protocols
Able to generate HIPAA transactions using mapping application tool and data from claims system
Experience with MS SQL Server or other Relational database systems and EDI transmission protocols
Healthcare industry experience as it relates to risk adjustment, medical claims submissions, adjudication and payment, eligibility, encounters file management in particular for Medicaid/Medicare populations
Ability to quickly assimilate new and existing technologies and products
Exemplary communication skills
Experience working with multiple cross-functional teams
Ability to effectively interpret and analyze data
Proficient in MS Word, Excel, Access, Visio, and PowerPoint
Ability to maintain high level of confidentiality
What’s in it for you:
Health and Life Insurance Plans
Dental and Vision Plans
401(k) with a company match
Flexible Scheduling
Paid Time Off and Holiday Pay
Maternity/Paternity Leave
Casual Dress Environment
Tuition Reimbursement
MTM Perks Discount Program
Leadership Mentoring Opportunities
Salary Min: $90,000
Salary Max: $120,000
This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss with us as you move through the selection process.
Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law. If you are in need of accommodations, please contact MTM’s People & Culture.