1+ months

EDI Engineer, Sr. (MapForce)

Myrtle Point, OR 97458
  • Jobs Rated
    8th
Regular Full Time
   

Responsibilities:
As part of the data platform team for the Healthcare Eligibility business segment, the Sr. EDI Engineer (MapForce) is responsible for providing integration/mapping expertise between Healthcare Services Coordination of Benefits (COB) data warehouse and payer network. The team member in this role will manage the development and onboarding of new EDI Trading Partners, develop onboarding plans, test plans, and go live rollout plans. Work in tandem with the Solution Architect, other EDI Engineers, and EDI Support Specialist, to help envision future strategies and direction to align with business initiatives. The Sr. EDI Engineer must be comfortable solving complex issues and well versed with Altova MapForce or similar tool.

Essential functions include, but are not limited to:
Assist with the mapping of data to/from common EDI formats to/from various formats
Design and write transaction processing edits, transforms, and workflow
Support the processing of healthcare EDI (Electronic Data Interchange) transactions, including:
-837 Claims
-835 Remittance
-270/271 Eligibility Inquiry and Response
-276/277 Claim Status Inquiry and Response
Monitor and support the operations of computer applications, services, and integrations, including software, hardware, operating systems, database, network, and related components to ensure products comply with business needs and SLAs
Develop configuration specifications and flowcharts as needed, develop, and maintain clear and succinct documentation
Telework in adherence with Company policies and requirements. 
Other duties and assignments as required to meet business needs


*Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performants policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

 


Required Skills and Knowledge:
Detailed knowledge of relevant healthcare EDI transactions (e.g., 837, 835, 270/271, and 276/277)
Experience with healthcare data types, including claims for medical, pharmacy, dental and other claim types
Demonstrated competence working with Altova MapForce or similar data mapping tool
Understanding of database structure and ability to query database elements for research
Experience working in a fast-paced environment leveraging Agile development practices
Understanding of at least one versioning control methodology and tool
Excellent communication and interpersonal skills
Think logically with ability to make sense of complex systems and leverage strong problem-solving skills to discover root causes
Team player collaborates effectively within the department and cross functionally
Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

 

Physical Requirements:
**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements). Basic office equipment required to perform remote work is provided by the company.
Job is performed in home-office setting (subject to Company approval and Teleworker Agreement), performs work at a desk or appropriate work surface, uses system and headset provided by the Company for calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse.
Reads and comprehends information in electronic (computer) or paper form (written/printed). 
Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.
Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.
Consistently communicates on the phone as required primarily within the department and company and may include client contacts or other third-party depending on assignment with account holders, may dial manually when need or use dialer system; headset is also provided.
Occasionally lift/carry/push/pull up to 10lbs.
Education and Experience:
Bachelors Degree in Computer Science or related field, or equivalent combination of education and work experience
5+ years of experience with healthcare EDI data mapping
5+ years SQL scripting experience
Must have experience with Altova MapForce or similar data mapping tool
Experience with Python, shell scripting, and/or structured data such as XML/JSON a strong plus


Other Requirements and Notices
Must submit to and pass pre-hire background check, as well as additional checks throughout employment
Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
Must submit to and pass drug screen pre-employment (and throughout employment).
Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.
  
Visa sponsorship is not available.


Job Profile is subject to change at any time.


EEO 
Performant Financial Corporation is an Equal Opportunity Employer. 
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 


NO AGENCY SUBMISSIONS (unless approved Performant agency partner with authorized job order for this specific job requisition)
   


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Posted: 2022-03-14 Expires: 2022-06-25

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EDI Engineer, Sr. (MapForce)

Performant Financial
Myrtle Point, OR 97458

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Software Engineer
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