Monterey Park, California
Sr EDI Programmer Analyst Job Opening in Monterey Park, California - *****No Sponsorship*****
GENERAL SUMMARY:
The Senior EDI Programmer/Analyst will provide technical programming and database expertise to solve complex EDI related business processes, formulate and devise application scope and objectives and work with the team in providing design inputs. It is expected that the applicant will be able to work independently and follow through on all aspects of SDLC.
The Programmer Analyst will be responsible for EDI related developing and enhancing encounter system/processes for inbound file loading, internal processing and outbound submissions to meet the established business rules, policies and procedures required by DHCS, CMS and regulatory entities as well as satisfy ad hoc requirements from regulatory bodies.
Essential Functions and Key Responsibilities (in descending order of importance) :
% of Time
Responsibility
65%
EDI related Design, Development, Testing, Implementation, Maintenance of Encounter Processing System and associated systems
15%
Work with Business Requirements
5%
Project Documentation
15%
Unit Testing
Minimum and Preferred Qualifications:
Experience
At least 5 years of programming experience in Oracle PL/SQL, SQL*Loader
At least 5 years of programming experience in Software Development Life Cycle
At least 2 years of experience in Unix flavor Operating Systems
Ability to work independently in a fast paced environment Education:
*
Minimum Bachelor's degree in Computer Science, Information Technology (IT) or related discipline that includes technology concentrations from an accredited university
A Master?s degree in Computer Science related discipline is desirable.
Training:
*
Skills/Abilities:
Develop HIPAA compliant ANSI X12 EDI transactions and support in EDI and other application development
Develop transaction maps, processes and jobs/plans for automation using tools such as Altova MapForce, GenTran, SQL Server and Oracle.
Provide on-going maintenance support to EDI and HIPAA transactions, processes and application development.
Test the EDI transactions with trading partners and other certification authorities as needed for compliance with the state and/or federal government regulations. Continuous developments of HIPAA compliant ANSI X12 EDI transactions as changes and addendums are published by WPC.
Drive HIPAA transactions development to complete them in time as required by HIPAA deadlines.
Assist in identification and development process to securely transfer EDI and HIPAA compliant transactions between PHC and trading partners.
Participate in negotiation of trading partner agreement and implementing transactions with each trading partner.
Provide assistance to providers in preparing HIPAA-compliant transactions for PHC. Provide training and assistance to less experienced staffs as needed.
Create and maintain documentation for all projects and participate in team meetings, conferences and problem solving discussions.
Programming experience in Oracle PL/SQL, SQL Loader, Unix Shell programming.
SSIS, SSRS skills are highly desirable.
Familiarity with EDI and XML processing is desirable. Candidate should be very familiar with Windows, Unix operating systems
Prior experience of working with Encounter Processes and Transactions (837P, 837I, 837D and NCPDP 4.2 transactions, EVR, 999/777/MAO) along with knowledge of healthcare member eligibility, provider network, claim processing, National Standard Codes is highly desirable
Solid communication skills (oral, written, and presentation) and strong interpersonal skills are essential.
Identify production & non-production application issues, identify opportunities, make recommendations to fine-tune and optimize system, processes, and management.
Provide EDI related technical support and consultation to system and processes, serve as a mentor as a technical expert for the team.
Communicate effectively with team members
Ability to complete work in a timely manner
Ability to work in a demanding environment
Job Type: Full-time
Job Location:
Monterey Park, CA
Required education:
Bachelor's
Required experience:
Unix flavor Operating Systems: 2 years
Programming in Oracle PL/SQL: 5 years
Programming in SDLC: 5 years
EDI and HIPAA: 1 year
Healthcare environment: 2 years
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