Job Description
The EDI Lead manages and responsible for the overall EDI/Interoperability process. The position is responsible for managing, planning, and guiding the daily EDI operations and ensuring the plan’s Trading Partners, contracted networks, hospitals, government agencies and providers transactions (X12, HL7, NCPDP, Proprietary, FHIR) are in compliance with HIPAA, CMS, DHCS and DMHC mandates, regulations and policies. This position also includes the role of liaison between all the internal Business Units for all EDI/Interoperability requirements, particularly eligibility, provider data, claims, clinical data and encounters. In addition, develop and provide oversight of EDI/Interoperability processes and documentation. The lead is responsible for all EDI/Interoperability related projects. The Lead manages all EDI/Interoperability priorities and assignments working with the IT Applications Managers and Director.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Required Skills & Experience
Bachelor’s degree or higher or relevant industry experience
· Proven experience as an EDI analyst, with a minimum of 5 to 7 years
· Knowledge of Qnxt and/or other Cognizant solutions.
· Minimum 5-7 years of experience using Edifecs products preferred
· PC literacy and demonstrated experience with MS Office (Outlook, Word, Excel, PowerPoint)
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.