*Need EAD GC or USC Only*

*Location          :      **MD-Maryland/Baltimore*
*Duration         :      6+ Months*



*Phone and face-face RequiredScope and Purpose of Position:*

·     Primary job responsibility is to assume responsibilities for the
development and internal *processes related to the eligibility and claims
adjudication systems 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 tools.*

·     *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 implementations.

·     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
request.

·     Produce comprehensive documentation of all developed software &
repositories.

·     Automation of routine processes with appropriate monitoring controls.

·     Other duties as assigned.

*Qualifications:*

·     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 is helpful.*

*Competencies:*

·     *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.

·     *Previous experience in a healthcare claims adjudication system.*

·     *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 plus.







Regards,
Upendra Nath
(Deputy Resource Manager)
Ramy Infotech Inc
Phone : 408-317-9256 Ext-311

Please Note: Due to high volume of calls, I may miss your call, email is
the better way to reach me.

*Note: We are working with prime vendor (One Layer between) for this
position.*

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