*please check and let me know*
*Kindly mail me at nik...@apetan.com <nik...@apetan.com>*
*Mode: Phone and Skype*
*Location: Linthicum, MD*
*Duration: 2-3 month contract *
New role I’m working on. 2-3 month contract , so would need you to be able
to release your consultant at time of potential hire with no additional
fees. On-site in Linthicum, MD. US citizens or Green Card holders only.
Willing to hire from Skype. Need healthcare experience. Candidates need to
be very strong in EDI 834 or EDI 837 (development, mapping, writing
queries, etc). Rate is. Overall, needs to be strong with EDI 834 or 837,
HIPAA/Healthcare, and SQL.Candidate must send me write up of 834 or 837
experience (whichever they are stronger with) before I can submit.
*Scope and Purpose of Position: *
Primary job responsibility is to assume responsibilities for the
development and internal processes related to the eligibility and claims
adjudication system's file processing.
*Major Duties and Responsibilities: *
Primary development role related to the eligibility and claims adjudication
system and internal processes.
Responsible for importing data feeds into Oracle database or exporting data
from the database into appropriate EDI formats to support member
'eligibility' and 'encounter' business processes.
Responsible for developing and testing HIPAA EDI 5010 X12 mapping formats
(834,837,277,999) as well as industry standard and custom formats using ETL
Review, evaluate, design and implement systems processes to ensure data
integrity is consistently maintained.
Coordinate with external clients and internal operations depts. to ensure
effectual setup and design of data formatting and flow for new client
Own and project manage the development of ongoing implementations start to
finish from client meeting and companion guide, through internal testing
process and development and into production with documentation.
Provides ad-hoc data/reports to clients or internal departments per
Produce comprehensive documentation of all developed software &
Automation of routine processes with appropriate monitoring controls.
Other duties as assigned.
*Education: *Bachelor's Degree in Computer Science or related field.
*Experience: *Minimum of 3-5 years relevant work experience and experience
in managed health care
Prior experience in EDI Programmer/Analyst role.
Accuracy, attention to details.
SQL Server database (2012)
SQL Server Integration Services (SSIS)
SQL Server Reporting Services (SSRS)
Experience in implementation of control and reconciliation reports.
Advanced knowledge and understanding of relational database environments.
2 Must have Previous experience in a healthcare claims adjudication system.
and strong healthcare background
Experience developing encounter and eligibility transactions set maps and
processes in HIPAA EDI 5010 X12.
Experience writing PL/SQL queries in Oracle or SQL Server.
Experience with an ETL and data mapping tools.
Experience in structured, data-driven, functional logic programming
Team oriented with the ability to work effectively across functional areas
of the company.
Excellent analytical, problem resolution and people skills.
Ability to deliver quality results under tight deadlines.
Excellent customer service orientation.
Ability to work independently with moderate supervision.
Understanding of vision care insurance or health care insurance data is a
Apetan Consulting LLC
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