WHAT DOES AN ELECTRONIC DATA INTERCHANGE SPECIALIST DO?
Published: Dec 19, 2024 - The Electronic Data Interchange Specialist ensures billing data accuracy, researches and revises process errors or claims, and maintains detailed records. This role involves interacting with staff, payers, and agencies to resolve issues, monitor clearinghouse reports, and guarantee claim payments. Additionally, the specialist anticipates insurance trends, assists in the creation of manuals and protocols, and maintains positive communication with the team.
A Review of Professional Skills and Functions for Electronic Data Interchange Specialist
1. Electronic Data Interchange Specialist Duties
- Vendor Relationship Management: Assists in managing vendor relationships with EDI partners.
- System Analysis & Design: Analyzes, designs, documents, and develops specifications for enhancements and extensions with EDI application interfaces and maps.
- Stakeholder Liaison: Acts in a liaison capacity with EDI service providers, trading partners, and internal business units.
- Process Support: Supports internal business processes with EDI solutions.
- Project Coordination: Coordinates EDI testing and trade partner implementation initiatives.
- Issue Management: Manages, researches, and resolves operational or production issues.
- Reporting & Query Development: Develops reports and queries.
- Project Management: Creates and manages a project plan (Excel, or other similar software).
- Communication Management: Communicates any schedule conflicts, resource, and time constraints to the project manager.
- Technical Troubleshooting: Tracks and facilitates resolution of technical problems.
- Resource Planning: Provides planning and resource allocation services that support the project schedule.
- EDI Project Management: Manages EDI projects, changes, and technical support.
2. Electronic Data Interchange Specialist Details
- Billing Accuracy Verification: Verifies the accuracy of billing data.
- Error Resolution: Researches and revises errors in processes or claims.
- Record Keeping: Maintains detailed records.
- Stakeholder Interaction: Interacts with staff, payers, and agencies to answer questions, obtain information, and resolve issues.
- Reporting Monitoring: Monitors clearinghouse reports and takes necessary steps to guarantee payment of claims.
- Information Coordination: Coordinates and collects necessary information from staff or payers for claim adjudication.
- Problem Account Identification: Recognizes problem accounts and notifies appropriate staff or supervisors to assist in problem resolution.
- Trend Analysis: Anticipates insurance trends and advises the supervisor of changes.
- Documentation Assistance: Assists in the creation of manuals and protocols.
- Support Coverage: Acts as backup coverage for associates.
- Communication Maintenance: Maintains open and positive, team-oriented lines of communication with the manager and other staff members.
3. Electronic Data Interchange Specialist Responsibilities
- EDI Monitoring: Follows up on all failed EDIs daily.
- Data Accuracy: Observes data records to track errors and correct failures.
- Cross-Departmental Support: Works with employees within the sales, operations, and customer service departments to support accurate, proper data exchanges.
- Pricing Setup: Works with the appropriate teams to set up missing pricing information.
- EDI Networking: Establishes EDI contacts with retail partners and coordinates setups.
- EDI Testing & Troubleshooting: Assists with testing new EDI implementations and troubleshooting issues.
- Project Support: Supports additional projects necessary to aid in the growth of Blueair’s operations.
- Technical Translation: Translates business requirements into technical solutions (BA + Developer).
- System Development & Support: Builds and tests systems and provides technical support.
- Team Training: Trains junior team members.
- Process Optimization: Analyzes and suggests process improvements.
4. Electronic Data Interchange Specialist Job Summary
- EDI VAN Setup: Supports EDI VAN for setup of new/existing customers and various document types.
- EDI Technical Support: Provides EDI support in analyzing and solving technical issues.
- System Configuration & Management: Performs system configuration, mapping, and management for EDI-based transactions and processes including 810s, 850s, 846s, 856s, 997s, identifies mapping issues or bad data.
- Data Maintenance: Updates/maintains lookup/translation tables.
- EDI Efficiency Improvement: Finds and implements efficiencies and improvements within current EDI integrations.
- Cross-Departmental Assistance: Assists departments and external consultants in EDI/JDE requirements, analysis, business process documentation, and IT specifications.
- EDI Testing & Validation: Tests EDI transactions with new and existing trading partners while performing user acceptance testing.
- Strategic System Planning: Participates in and supports system planning and the development of long-term strategic goals for systems and software in conjunction with company long-term strategies.
- Solution Deployment: Deploys solutions to serve the needs of the company’s business requirements.
- Relationship Management: Establishes and deepens relationships with partners by understanding business objectives and providing exemplary support.
- EDI/XML Mapping: Creates and tests EDI to XML mapping.
- Business Analysis & Problem Solving: Provides analysis and potential solutions to the business staff to solve business problems or streamline operations.
- Team Management: Manages the EDI Analyst team.
5. Electronic Data Interchange Specialist Accountabilities
- Partner Collaboration and Project Management: Works with trading partners and manages EDI and API integration projects.
- Lifecycle Project Management: Effectively manages projects through a full project lifecycle process and supports related customer needs.
- EDI Analysis: Analyzes EDI and data requirements from customers.
- Implementation Standards Maintenance: Maintains client implementation standards and timelines by applying project management processes.
- Communication Coordination: Communicates with customers and internal project teams and management to pass along information regarding project and customer requirements, progress, resources, and resolution.
- Multi-Project Management: Concurrently works on/with multiple projects, multi-level resolution teams, and customers to help resolve technical issues from the customer's and project team's perspective.
- Error Resolution Monitoring: Monitors and solves daily error reporting through the implementation of automated solutions.
- Advanced Support Provision: Provides support and researches solutions for user issues that cannot be resolved through data entry corrections and tier 1 support.
- EDI Systems Improvement: Works to maintain and improve all EDI systems and capabilities.
- Integration Requirement Analysis: Gathers information to define and execute any and all EDI integration requirements.
- Project Planning and Management: Creates project plans and manages those plans.
- Vendor Collaboration: Works with third-party vendors on EDI solutions.