What Will Your Job Look Like?

The EDI Developer will work with MTM clients to ensure timely and accurate EDI onboarding (for new clients) and ongoing production support of EDI file transmissions, while continuously improving the department EDI processes and systems, resulting in the highest value possible for MTM customers. The position will be responsible for developing, testing, and implementing EDI processes and will function as EDI development expert assisting and training other EDI team members.  The EDI Developer will maintain and operate the EDI systems, implement encounter, eligibility, other EDI transactions and related reports, analyze and research EDI issues, perform other EDI requests, projects, and tasks.  The EDI Developer will perform within department policies and procedures, regulatory, contractual timeframes and guidelines, and management direction.

What You’ll Do:

• Analyze, design, develop, test, troubleshoot, optimize, enhance and maintain EDI applications in various formats that include HIPAA standard formats such as 834, 835, 837, 277 and other proprietary formats using EDI mapping tools
• Create and maintain interfaces between applications systems and EDI transactions
• Maintain detailed documentation and process flow of all EDI processes
• Apply in-depth knowledge of systems and business to the development of technical design for large complex processes and projects
• Evaluate user requests for new and modifications to EDI applications/programs/processes/maps
• Conduct research and make recommendations on products, services, protocols, and standards in support of EDI processing and data transfer efforts
• Participate in project meetings, providing input to project plans and providing status updates
• At the request of end users or management, research questions involving EDI applications and how the data is organized and populated
• Provide status updates on all assigned tasks
• Follow existing source code management and version control processes for all coding efforts
• Perform maintenance and enhancements to the EDI system and database
• Perform technical analysis and data mining for EDI reporting requests from internal and external customers
• Support internal and external integration channels to the EDI system to ensure data interchange meets technical expectations and criteria
• Ensure the validity of EDI transactions and accuracy of EDI reporting via technical quality control measurements and practices
• Manage and ensure quality and consistent delivery for EDI transactions
• In collaboration with others, develop and maintain databases necessary for projects and department functions
• Acquire and abstract primary or secondary data from existing internal or external data sources
• In collaboration with others, interpret EDI data and develop recommendations based on findings
• Generate routine and ad hoc reports
• Assist in managing Client expectations and project planning/implementations
• Develop detailed source to target mapping from client data to our EDI specifications as well as data transformation documentation and explain the mapping to team members
• Develop strategies and standards to improve the customer onboarding process and experience
• Query data, compile data analysis, trends, error analysis and other information to assist clients to improve their EDI transactions
• Act as the liaison between Business partners, clients, and IT
• Manages work plans and timeliness
• Ability to work with local and remote staff and consulting partners

What You’ll need:

• High School Diploma or G.E.D equivalent
• Bachelor's degree or 4+ years of EDI Development experience
• 3 - 5 years’ experience in EDI development, tools and HIPAA/X12 standards
• 3 – 5 years’ experience with Relational databases, such as Microsoft SQL Server
• Exposure and general understanding of Healthcare claims processing
• Ability to write SQL queries to extract data from databases/ODS

Even better if you have...

• 2 years of experience in health care industry, preferred
• Preferred experience in Agile, MS SharePoint, Project Management
• Development experience with 834, 835, 837, 277 and other standard EDI transactions
• Clear understanding & working knowledge of HIPAA EDI protocols
• Able to generate HIPAA transactions using mapping application tool and data from claims system
• Experience with MS SQL Server or other Relational database systems and EDI transmission protocols
• Healthcare industry experience as it relates to risk adjustment, medical claims submissions, adjudication and payment, eligibility, encounters file management in particular for Medicaid/Medicare populations
• Ability to quickly assimilate new and existing technologies and products
• Exemplary communication skills
• Experience working with multiple cross-functional teams
• Ability to effectively interpret and analyze data
• Proficient in MS Word, Excel, Access, Visio, and PowerPoint
• Ability to maintain high level of confidentiality

What’s in it for you:

• Health and Life Insurance Plans
• Dental and Vision Plans
• 401(k) with a company match
• Flexible Scheduling
• Paid Time Off and Holiday Pay
• Maternity/Paternity Leave
• Casual Dress Environment
• Tuition Reimbursement
• MTM Perks Discount Program
• Leadership Mentoring Opportunities

Salary Min: $100,000

Salary Max: $120,000

• This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss with us as you move through the selection process.

Equal Opportunity Employer: MTM is an equal opportunity employer.  MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law.  If you are in need of accommodations, please contact MTM’s People & Culture.