The EDI Analyst will support inbound and outbound EDI submissions of HIPAA compliant transactions, including 270/271, 276/277, 837I, 837P, 835 and 999/TA1.
-Provide ongoing support to EDI testing/research and for new initiatives.
-Report to the Manager of EDI Trading Partner Testing (this role is integral to EDI functions that MAXIMUS performs for MassHealth).
-Apply systems analysis techniques to identify and determine root cause of electronic file submission failures for the following transaction sets utilizing industry standards (Washington Publications Implementation Guides, MassHealth Companion Guides, American National Standards Institute X12).
-Outreach to MassHealth Trading Partners with results of analysis and resolutions of the EDI transaction sets.
-Provide direction to the provider on how to resolve or make computer systems changes to correct the file.
-Handle communications with Trading Partners for EDI transaction set-up and ongoing maintenance and support.
-Thoroughly document EDI transaction issues and communicate critical issues to the Provider Services leadership team.
-Utilize a support console to track testing status and results; make notes of errors and resolutions; and log the type of, reason for, and results of communications with the Trading Partners.
-During testing implementations, assist in the technical design and workflow of the Trading Partner testing process.
-Work with MMIS Information Technology development staff to resolve Trading Partner testing errors as swiftly as possible and make recommendations on system modifications.
-Maintain compliance with contract requirements related to EDI Trading Partner Testing.
-Participate in ongoing communication between the EDI team, the Contact Center, and Provider Relations staff to optimize customer service to the provider community.
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