Job Summary:

• Administer and coordinate all aspects of the EDI communication between company customers, and vendors.
• Set up and document new EDI process, including analyzing customer requirements, designing EDI map documents and setup on ERP system.
• Prepare test data and perform tests on all EDI transmissions and produce operational documents for end users.
• Troubleshoot processes to resolve content issues and map problems.
• Monitor production EDI transmissions.
• Provide technical support for the EDI program, resolve EDI application issues and maintain all processes to manage inbound and outbound data.
• Handling maintenance and changes to insure smooth transitions when required
• Implementing and Creating EDI program guidelines
• Be the initial point of contact for troubleshooting inquiries and partnering closely with IT staff and stakeholders across the organization
• Testing and upgrading data mapping and applications to support data processes
• Perform system audits, communicate results and train users

Skills on Resume:

• Administering EDI Communication (Hard Skills)
• Setting Up EDI Processes (Hard Skills)
• Testing EDI Data (Hard Skills)
• Troubleshooting EDI Issues (Hard Skills)
• Monitoring EDI Transmissions (Hard Skills)
• Providing EDI Technical Support (Hard Skills)
• Implementing EDI Guidelines (Hard Skills)
• Performing System Audits (Hard Skills) 

Job Summary:

• Work with trading partners, 3PLs, and 3rd party EDI providers to setup, configure, and map EDI documents
• Work with internal business units and IT to validate end-to-end EDI functionality
• Map specific EDI documents using customer-provided specifications
• Troubleshoot EDI document processing errors and work with trading partners to resolve in a timely matter
• Set up communication with customers and validate certificates etc.
• Support internal resources to resolve issues, answer questions, and retransmit EDI documents
• Work with end users to ensure user acceptance testing is thorough and complete
• Document business requirements for new integrations, documents and forms
• Responsible for increasing the auto-adjudication rate of claims received through EDI. 
• Targets are defined annually through departmental major strategic objectives.
• Manages all communications with internal departments, as well as contracted providers, concerning submittal issues that require troubleshooting.
• Responsible for administrating the Health Plan’s relationship with Clearinghouse vendors.

Skills on Resume:

• Configuring EDI Documents (Hard Skills)
• Validating EDI Functionality (Hard Skills)
• Mapping EDI Documents (Hard Skills)
• Troubleshooting EDI Errors (Hard Skills)
• Setting Up EDI Communication (Hard Skills)
• Supporting EDI Issue Resolution (Soft Skills)
• Conducting User Acceptance Testing (Soft Skills)
• Documenting Business Requirements (Hard Skills) 

Job Summary:

• Responds to requests for first-level support/general technical assistance via phone, and e-mail.
• Diagnoses and resolves technical hardware and software issues.
• Assists all customers with questions about any of the supported software, applications and computing platforms, to the best of his/her ability, in a professional and courteous manner.
• Creates submitter accounts, manages and configures those accounts, and deletes accounts due to non-activity.
• Timely and accurate data entry of Account Request forms is required.
• Safeguards system account password information and has access to verbal, written and/or electronic protected healthcare information as defined by HIPAA and Beacon Health Options.
• Stays abreast of current news, system information, problems, changes and updates relevant to user community.
• Researches questions using a variety of manuals and resources.
• Familiarize themselves with the research and information resources and knowledge bases at hand.
• Finds answers to all questions addressed to them personally or with assistance.
• Working with internal and external customers for inquiry resolution.

Skills on Resume:

• Providing Technical Support (Soft Skills)
• Diagnosing Issues (Hard Skills)
• Assisting with Software (Soft Skills)
• Managing Accounts (Hard Skills)
• Data Entry (Hard Skills)
• Safeguarding Information (Hard Skills)
• Staying Informed (Soft Skills)
• Researching Inquiries (Hard Skills) 

Job Summary:

• Interfaces with Service Centers, Corporate Departments and all Beacon Health Options staff and maintain close working relationships with all to ensure the highest level of customer satisfaction is met.
• Advises user on appropriate action for customer resolution.
• Applies what is learned from previous technical experiences and builds on those as he/she progresses in his/her position and as he/she is faced with new questions and situations.
• Tracks and routes problems and requests and document resolutions.
• Identifies and escalates situations requiring urgent attention.
• Applies critical thinking skills to problem situations and excels in an environment with a high level of ambiguity.
• Follows Help Desk procedures and unit processes.
• Work projects as identified by management to support business needs.
• Tracks the incoming EDI file names, dates, claim counts, and fatal edits, including logged, run and processed files.
• Seeks quality improvements for the EDI process.
• Oversight and monitoring of claims reconciliation process for EDI claim submissions.

Skills on Resume:

• Maintaining Relationships (Soft Skills)
• Advising on Resolutions (Soft Skills)
• Building Technical Knowledge (Hard Skills)
• Tracking Issues (Hard Skills)
• Escalating Issues (Soft Skills)
• Critical Thinking (Soft Skills)
• Following Procedures (Hard Skills)
• Monitoring EDI Processes (Hard Skills)

Job Summary:

• The primary role is the day-to-day operations of all EDI functions, including incoming sales orders and outgoing shipping notices and invoices.
• Manage all EDI projects and communicate directly with trading partners.
• Feed and troubleshoot EDI transactions into and out of the backend ERP system.
• Work with 3rd party to make sure we follow EDI guidelines from all EDI major trading partners and implement any updates pertaining to EDI transactions.
• Maintain a working interface with the company's ERP system.
• Review, track and ensure document transmissions in a timely manner.
• Review charge-backs and follow up with the Accounts Receivable department for EDI non-compliance charge-backs assessed.
• Set up and coordinate tests with Operations and Warehouse for new trading partners on EDI.
• Work to assist other departments (such as Sales and Warehouse) to prevent chargebacks.
• Perform Quality Control on all setups, modifications, and updates to the EDI System.
• Maintaining Customer Ship-to addresses
• Maintaining and uploading customer contracts

Skills on Resume: 

• EDI Management (Hard Skills)
• ERP Systems (Hard Skills)
• Data Troubleshooting (Hard Skills)
• Quality Control (Hard Skills)
• Project Coordination (Soft Skills)
• Cross-Department Support (Soft Skills)
• Communication (Soft Skills)
• Documentation Maintenance (Hard Skills)

Job Summary:

• Coordinate and test EDI integrations with new trading partners and vendors
• Analyze customer EDI specification documents to ensure mapping requirements are accurately met and implemented
• Provide technical support for EDI stakeholders to resolve any transactional and/or operational issues that may arise
• Collaborate with team members to assess, troubleshoot, and enhance existing and future EDI integrations and processes
• Complete profile setups to drive EDI transactions with various vendors
• Coordinate with IT for EDI developer to test all transactions from new vendors.
• Provide a daily administrative report for all EDI transmissions identifying and critical errors or issues and providing an Error profile.
• Monitor all “Expected {EDI} Transaction Activity to ensure all transmissions are being executed
• Troubleshoot all issues and initiate help with IT
• Clean up all EDI errors each day. 
• Work with the teams to resolve any identified issues.

Skills on Resume:

• EDI Integration Testing (Hard Skills)
• Specification Analysis (Hard Skills)
• Technical Support (Soft Skills)
• Collaboration (Soft Skills)
• Profile Setup (Hard Skills)
• IT Coordination (Soft Skills)
• Reporting (Hard Skills)
• Error Resolution (Hard Skills)

Job Summary:

• Ensure the flow of information following shipment from source to invoicing to appropriate parties in a timely manner.
• The Sales Support Team oversees priorities, fulfillment, shipment of orders/invoicing, inter-company transfers, return authorizations based on sales team priorities.
• Serve as a liaison among communications with Sales, Traffic, Distribution Center (DC), Inventory Control, and Accounts Receivable.
• Monitor and compile all necessary information outlining the lifespan of an order from the initial ETA date through invoicing for the US Sales team
• Monitor inbound delivery of the product (frequency based on outbound date and priority of order) and call out issues with recommended actions as necessary to sales and DC.
• Assist in following up with the traffic department to ensure PO’s are received so sales orders can be shipped on time
• Assist, as needed, the sales team in updates of bulk orders based on changes per production and DK buying offices
• Monitor Open order reports for EDI customers to ensure timely receipt of EDI orders, taking into account the time needed to import, reconcile and process orders and the overall workload of the DC to ensure timely shipment
• Confirm pricing and Important EDI orders.
• Validate orders against bulk orders.
• Once validated, activate the EDI order and cancel the bulk order
• Once sales and EDI orders has imported Sales support will validate the units available to sales order using the Order status
• Upon sign-off on the EDI order, Sales support may need to adjust pricing via discounts for the EDI order

Skills on Resume:

• Information Flow Management (Hard Skills)
• Sales Support Coordination (Soft Skills)
• Cross-Department Liaison (Soft Skills)
• Order Lifecycle Monitoring (Hard Skills)
• Inbound Delivery Monitoring (Hard Skills)
• Purchase Order Follow-Up (Soft Skills)
• EDI Order Validation (Hard Skills)
• Pricing Adjustment (Hard Skills)

Job Summary:

• Distribution of units based on customer priorities and availability of inventory to ensure best possible fill rates and on-time shipment coordinating with sales teams on big issues
• Ensure deliveries are met within the designated shipping window provided by US Sales Team or Supply Chain
• Manage order release according to delivery windows and Supply Chain instructions
• Support Distribution Center and monitor KPI for Wholesale deliveries and shipments
• Manage Wholesale Return Authorizations
• Facilitate intercompany transfers between Wholesale and dropship channels
• Maintain Wholesale customer master in conjunction with Accounts Receivable and Vendor Guidelines
• Communicate and coordinate with internal departments in order to meet customer expectations
• Manage chargebacks by category of non-compliance.
• Investigate and dispute chargeback claims and proceed with credit notes
• Adhere to precision, quality and timing standards to ensure the best quality service

Skills on Resume:

• Inventory Distribution (Hard Skills)
• Delivery Monitoring (Hard Skills)
• Order Management (Hard Skills)
• KPI Tracking (Hard Skills)
• Return Processing (Hard Skills)
• Intercompany Transfers (Hard Skills)
• Customer Data Maintenance (Hard Skills)
• Chargeback Resolution (Hard Skills)

Job Summary:

• Conduct independent analysis of business and technical issues and recommend alternative solutions, including development effort estimates
• Create or modify low to medium-complexity, technical software designs based upon the analysis of business requirements
• Create or modify, test, and install software modules, including system documentation
• Coordinate software development activities with project team members, including mentoring other staff members
• Assume on-call support activities
• Work with representatives of the user community to define and document system requirements, report progress and status, develop and coordinate system testing, assist with training, and develop user documentation
• Perform all development activities according to department standards
• Maintain proficiency in the languages and platforms required to develop applications
• Conform to all development and support activity deadlines
• Report development status to IT management, including all unanticipated events affecting development

Skills on Resume:

• Business Analysis (Hard Skills)
• Software Design (Hard Skills)
• Module Development (Hard Skills)
• Team Mentoring (Soft Skills)
• On-Call Support (Soft Skills)
• Requirement Documentation (Hard Skills)
• Standards Compliance (Hard Skills)
• Progress Reporting (Soft Skills) 

Job Summary:

• Provide Billing SME support for existing interfaces
• Analyze requests for EDI file set-up, including but not limited to, membership, claims, encounters, provider data
• Clearly and timely communicate required EDI information between different parties
• Proactively monitor and analyze production EDI files for quality, accuracy, adherence to standards and mapping
• Quantifies billing error trends and implements appropriate process changes
• Identifies and submits EDI, ERA and EFT enrollment to all carriers
• Implements billing guidelines at a payer-specific level
• Resolves issues related to payment misrouting through discovery and research
• Maintains and updates remit address changes with government and commercial payers weekly, monthly or quarterly
• Draft supporting documentation and submit for signatures
• Assist with the scanning and upkeep of all enrollment documentation
• Support with special projects related to RCM team objectives
• Manage payor website logins, grant new access, deactivate access and provide password resets

Skills on Resume:

• EDI Expertise (Hard Skills)
• Billing Process Knowledge (Hard Skills)
• Clear Communication (Soft Skills)
• Quality Monitoring (Hard Skills)
• Error Trend Analysis (Hard Skills)
• Payer Enrollment Management (Hard Skills)
• Payer-Specific Billing (Hard Skills)
• Documentation Management (Hard Skills) 

Job Summary:

• Onboarding new customers.
• Analyze and interpret business/systems requirements for EDI customers
• Document/Mapping Development/Setup, testing, deployment, and support x12 transactions – Retail/Grocery Industry TLi GS1/UCC-128 setup (BC400)
• Trading Partner relationships and communications
• Daily monitoring of EDI transactions including troubleshooting of invalid/failed EDI transactions, and resolving errors in data.
• Investigating/resolving EDI-related non-compliance and customer-assessed penalties.
• Work as part of the team on EDI upgrades
• Assist with maintenance of provider portal databases to ensure accurate demographics for all practices
• Assist with creation and maintenance of tracking sheets
• Provide W9’s and ensures contracted payers receive updated information
• Extensive follow up with payers up to the completion of enrollment
• Requesting pertinent information from other departments for enrollment purposes
• Respond to team requests via email, phone and Service Now

Skills on Resume:

• Customer Onboarding (Soft Skills)
• EDI Requirements Analysis (Hard Skills)
• EDI Mapping and Testing (Hard Skills)
• Trading Partner Management (Soft Skills)
• EDI Transaction Monitoring (Hard Skills)
• Non-Compliance Resolution (Hard Skills)
• EDI System Upgrades (Soft Skills)
• Data Maintenance (Hard Skills) 

Job Summary:

• Develop new EDI Maps/Processes/IDOCs and work with appropriate IT personnel and business contacts
• Manage EDI implementation projects with Trading Partners
• Implement EDI messages and transactions with SBD trading partners
• Use the EDI / SAP testing system and perform data verifications to analyze EDI map accuracy and resolve discrepancies.
• Manage problems through analysis, resolution, troubleshooting and root cause analysis
• Continuously explore areas for process improvements
• Coordinate the daily monitoring of EDI translations and support requests. 
• Work with appropriate areas in resolving issues.
• Responsible for administrating the Health Plan’s relationship with Clearinghouse vendors.
• Tracks the incoming EDI file names, dates, claim counts, and fatal edits, including logged, run and processed files.
• Seeks quality improvements for the EDI process.
• Oversight and monitoring of claims reconciliation process for EDI claim submissions.

Skills on Resume:

• EDI Mapping Development (Hard Skills)
• EDI Project Management (Soft Skills)
• EDI Message Implementation (Hard Skills)
• EDI Testing (Hard Skills)
• Problem Resolution (Hard Skills)
• Process Improvement (Soft Skills)
• EDI Monitoring (Hard Skills)
• Vendor Management (Hard Skills)

Job Summary:

• Primary role is the day to day operations of all EDI functions, including incoming sales orders and outgoing shipping notices and invoices.
• Manage all EDI projects and communicate directly with trading partners.
• Feed and troubleshoot EDI transactions into and out of backend ERP system.
• Follow EDI guidelines from all EDI major trading partners and implement any updates pertaining to EDI transactions. 
• This includes work to maintain a working interface with the company’s ERP system.
• Review, track and ensure document transmissions in a timely manner.
• Review charge-backs and follow up with the Accounts Receivable department for EDI non-compliance charge-backs assessed.
• Set up and coordinate tests with Operations and Warehouse for new trading partners on EDI.
• Work to assist other departments such as Sales and Warehouse) to prevent chargebacks.
• Perform Quality Control on all setups, modifications, and updates to the EDI System.
• Targets defined annually through departmental major strategic objectives.
• Manages all communications with internal departments, as well as contracted providers, concerning submittal issues that require troubleshooting.

Skills on Resume:

• EDI Operations Management (Hard Skills)
• EDI Project Management (Soft Skills)
• EDI Troubleshooting (Hard Skills)
• EDI Compliance (Hard Skills)
• Document Transmission Monitoring (Hard Skills)
• Charge-back Management (Hard Skills)
• EDI Testing Coordination (Soft Skills)
• Quality Control (Hard Skills) 

Job Summary:

• Acts as the liaison between internal departments including IT and Configuration and the EDI Coordinators to handle day-to-day questions and issue resolution
• Responsible for training all staff on the EDI team, as well as training other department members
• Responsible for the implementation of the HIPAA transaction sets across the company (270/271, 276/277, 278, 820, 835, 837I and 837P)
• Responsible for representing the EDI Team in all meetings with internal and external customers
• Responsible for security set up for all online tools, including the Provider Tools and Employer Tools
• Responsible for documentation of all policies and procedures for the EDI team
• Responsible for running the KEA scripting software for the Weight Watchers claims
• Responsible for providing weekly updates on all Trading Partners in the testing phases
• Responsible for all testing of Edifecs and QNXT system upgrades or changes as they relate to electronic submission
• Accountable for testing new and updated technology applications to the current EDI logic and then communicating the results to appropriate departments.
• Leads the process of escalating the magnitude of providers who submit claims to Fallon Health through electronic submission, including actively seeking new enrollees to maximize the performance measures for Fallon’s EDI rate.
• Responsible for increasing the auto-adjudication rate of claims received through EDI. 

Skills on Resume:

• Liaison and Issue Resolution (Soft Skills)
• Training and Development (Soft Skills)
• HIPAA Transaction Implementation (Hard Skills)
• EDI Representation (Soft Skills)
• Security Setup (Hard Skills)
• Policy Documentation (Hard Skills)
• Software Management (Hard Skills)
• System Testing (Hard Skills) 

Job Summary:

• Administer and coordinate all aspects of the EDI communication between company customers, and vendors.
• Set up and document new EDI processes, including analyzing customer requirements, designing EDI map documents and setting up on ERP system.
• Prepare test data and perform tests on all EDI transmissions and produce operational documents for end users.
• Troubleshoot processes to resolve content issues and map problems.
• Monitor production EDI transmissions.
• Provide technical support for the EDI program, resolve EDI application issues and maintain all processes to manage inbound and outbound data.
• Responsible for EDI enrollments for assigned transactions, facilities, customers, and/or lines of business.
• Available to Providence RC Cash and Billing teams as first line of support in the case of missing 835 Remits or suspected issues with EDI Claims Runs.
• Responsible for monitoring and/or performing EDI reconciliation for assigned transactions, facilities, customers, and/or lines of business.
• Works with Providence RC Customers, including but not limited to Business Analysts, OIS/EPIC Analysts, and/or Vendors to resolve issues arising out of reconciliation that indicate any concern surrounding the optimal revenue flow for Providence St. Joseph Health and its affiliates.
• Provide and Monitor key metrics related to EDI processes such as % of Claims submitted via EDI, % of Cash Transactions Posted EDI, as well as overall incoming and outgoing volumes.
• Participate in ongoing projects or processes seeking to optimize EDI operations

Skills on Resume:

• EDI Coordination (Soft Skills)
• EDI Process Setup and Documentation (Hard Skills)
• EDI Testing (Hard Skills)
• Troubleshooting (Hard Skills)
• EDI Monitoring (Hard Skills)
• Technical Support (Soft Skills)
• EDI Reconciliation (Hard Skills)
• Metrics Monitoring (Hard Skills)