Medicaid EDI Manager

IDR is seeking a dedicated and detail-oriented Medicaid EDI Manager to join one of our top clients in Mason, OH. If you’re looking for an opportunity to work with a large organization in a team-oriented environment, please apply today!

Position Overview/Responsibilities for the Medicaid EDI Manager:
Serve as the subject matter expert for EDI transactions (EDI 837, 835, 820, 276/277, 278) for Medicaid and Medicare programs.

Lead the loading and validation of membership and claims data into the AS400 system.

Troubleshoot and resolve data issues through collaboration with internal teams and clients, ensuring the accuracy and timeliness of data submissions.

Work closely with internal teams to document and implement process improvements and data validation enhancements.

Utilize SQL for data analysis, troubleshooting, and gap analysis, ensuring the integrity and accuracy of data loads.

Manage multiple priorities and ensure work is completed within service level agreements (SLAs) while meeting team performance goals.

Required Skills for the Medicaid EDI Manager:
5+ years of experience as a Business/Business Systems Analyst in the healthcare industry, with a focus on Medicaid or Medicare programs.

Strong experience with EDI healthcare transaction sets, specifically EDI 837, 835, 820, 276/277, and 278.

Proficiency in SQL for data validation, troubleshooting, and gap analysis.

Experience working with AS400 systems for loading membership and claims data.

Strong understanding of Medicaid, Medicare, and healthcare claims processing.

What’s in it for you?
Competitive compensation package

Full Benefits: Medical, Vision, Dental, and more!

Opportunity to work with an industry-leading organization

Collaborative and team-oriented culture

Why IDR?
25+ Years of Proven Industry Experience in 4 major markets

Employee Stock Ownership Program

Medical, Dental, Vision, and Life Insurance

ClearlyRated's Best of Staffing® Client and Talent Award winner 11 years in a row
 #LI-Hybrid All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. IDR is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, we invite employees to voluntarily self-identify their race or ethnicity, gender, and veteran status (if applicable). Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. You may access this form here.