Harris Health System

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EDI Specialist

at Harris Health System

Posted: 4/12/2019
Job Status: Full Time
Job Reference #: 145406
Keywords:

Job Description

About Us

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Profile

The EDI Specialist maintains production of EDI processes using EDI tools and ensuring transactions are accurate when changes or maintenance are required. Processes inbound / outbound EDI files for enrollment, claims and encounter data.

QUALIFICATIONS:

  • Bachelor's Degree in Business, Information Technology, Computer Information Systems, Systems Engineering, related fields or four years of related work experience may substitute for the bachelor's degree.
  • Experience in Health Care, or with an HMO or MCO organization, preferred


OTHER SKILLS:

  • Above Average Verbal (Heavy Public Contact)
  • Writing /Composing(Correspondence/ Reports)
  • Medical Terms Statistical
  • MS Word /MS Excel
  • Ability to learn HIPAA regulations and requirements
  • Ability to learn HIPAA EDI transactions (820, 270, 271, 834, 837, 270, 271 etc...) and other file formats
  • ETL and database tools such as SSMS, SSRS, and SSIS.
  • Experience in Microsoft Outlook programs
  • Skill in critical thinking, problem analysis, and process documentation.
  • Excellent documentation, verbal and written communication and interpersonal skills
  • Excellent analytical and problem-solving abilities
  • Knowledge of Healthcare Business Systems desired
  • Ability to analyze detailed information and to follow written instructions



Benefits and EEOC

Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

Job Category

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Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!