EDI Developer

1 week ago(1/11/2018 1:17 PM)
Company
Noblis
Requisition #
5881
Security Clearance
None
FT/PT/On-Call
Full Time
Job Category
Systems Engineering
Location
US-MD-Woodlawn

Responsibilities

Centers for Medicare & Medicaid Services (CMS) provides health insurance to more than one third of all Americans. In addition, CMS is responsible for the administration of the health insurance exchanges developed by state governments and CMS. Noblis works with CMS to design, oversee and implement innovative health IT solutions across the data value chain. As part of the HHS Account team you will provide HIPAA Transactions and Code Sets expertise to support the ongoing systems maintenance and support to Medicare Fee-For-Services Claims Processing, Medicare Advantage and Part D, Beneficiary and Entitlement, and Health IT Economic and Clinical Health Act Systems:

  • Work directly with clients to identify, develop and support continuous improvement initiatives for EDI and X12N 5010 HIPAA transactions; uses best practices and awareness of internal or external business issues to improve X12N compliance
  • Ensure that Companion Guides provide the appropriate communication, connectivity and transaction specific information to Medicare FFS trading partners and serve as the authoritative source for Medicare Fee-For-Service specific EDI protocols 
  • Work with CMS to understand the business impact of changes being developed as part of the HIPAA transaction standard 6020 currently being developed as well as other emerging standards (e.g., blockchain, FHIR)  
  • Develop operational dashboards and conduct data analytics on CMS EDI transaction processing  
  • Work with Noblis Senior Leaders to communicate the vision and status to CMS business owners.

Qualifications

  • Bachelor of Science in Computer Science, Health Informatics, or a related field + 3 years experience 
  • Development of business-critical relationships with both CMS and other HHS divisions to foster continued adoption of selected innovations  
  • Ability to provide technical leadership on HIPAA 5010 X12N standards and supporting operating rules for the following adopted 5010 Transactions:
    • Claims and encounter information 
    • Payment and remittance advice  
    • Claims status  
    • Eligibility 
    • Enrollment and disenrollment 
    • Referrals and authorizations 
    • Coordination of benefits 
    • Premium payment
  • Experience with Agile
  • Understanding of CMS business processes and systems
  • Experiencecommunicating complex technical concepts to non-technical audiences (e.g., white papers, presentations, documents) 
  • Legally authorized to work in the U.S.
  • Ability to obtain a public trust clearance

Overview

Noblis and our wholly owned subsidiaries, Noblis ESI and Noblis NSP, are solving difficult problems that help our government and our country. We bring the best of scientific thought, management, and engineering expertise with a reputation for independence and objectivity. We support a wide range of government and industry clients in the areas of national security, intelligence, transportation, healthcare, environmental sustainability, and enterprise engineering. Learn more at noblis.org/about.

 

Why work at a Noblis company?

Our employees find greater meaning in their work and balance the other things in life that matter to them. Our people are our greatest asset. They are exceptionally skilled, knowledgeable, team-oriented, and mission-driven individuals who want to do work that matters and benefits the public.

 

Noblis has won numerous workplace awards. Noblis maintains a drug-free workplace and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race.

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