Utah Retirement Systems

  • EDI Specialist

    Location US-UT-Salt Lake City
    Posted Date 1 month ago(1 month ago)
    Job ID
    2018-2608
    Category
    Information Technology
    Minimum Starting Wage
    USD $23.33/Hr.
  • About The Company

    Utah Retirement Systems (URS) provides benefits for state and other Utah public employees.  It has two divisions.  The Retirement Office administers pension and retirement savings plans.  PEHP specializes in medical, dental, life, and other benefits. 

    Job Description

    Serves as primary point-of-contact for EDI related issues within the PEHP organization as well as for Trading Partners and Value Added Networks.

     

    REPORTING RELATIONSHIPS

    Works under the direct supervision of the EDI Manager.

     

    ESSENTIAL FUNCTIONS

    1. Acknowledges receipt of EDI claims and other EDI transactions, batch and real-time; resubmits outbound EDI transactions.
    2. Handles EDI Help Desk phone calls and emails.
    3. Manages and maintains Trading Partner set ups.
    4. Assists Provider Relations and Customer Service in resolving electronic claims/payment issues.
    5. Responsible for troubleshooting, researching, and analyzing error handling and exception reporting and reprocessing EDI activities as needed.
    6. Responsible for Electronic Funds Transfer (EFT) set ups.
    7. Maintains cross reference tables in the claims adjudication system for EDI and financial transactions.
    8. Documents new EDI Help Desk procedures as they are developed.
    9. Maintains strict confidentiality.
    10. Performs other related duties as required.

    Required Experience

    Education & Experience

    High School diploma, and two (2) years of practical experience in Healthcare Payment Cycle environment or two (2) years of practical experience in Electronic Data Interchange Support environment; or the equivalent combination of education and experience.

     

    College level courses in EDI, data structure, and/or networking is preferred.

     

    Knowledge, Skills, and Abilities

    This list contains knowledge, skills, and abilities that are typically associated with the job. It is not      all-inclusive and may vary from position to position:

     

    Required technical skills and working knowledge of:

    • Computer operations including Microsoft Exel.
    • File Editor.
    • EDI Translator.
    • FTP software.

     

    Required working knowledge of:

    • HIPAA transaction and code set standards.
    • Troubleshooting and solving problems.

     

    Required mathematical skills include working knowledge of:

    • Adding, subtracting, multiplying and dividing in all units of measure, using whole numbers, common fractions and decimals.
    • Computing rate, ratio, and percent.
    • Validating payments and claims amounts.

     

    Required communication skills:

    • Communicate effectively verbally and in writing.
    • Telephone etiquette.
    • Public relations.

     

    Must have the ability to:

    • Follow written and verbal instructions.
    • Take initiative when new issues arise.
    • Work effectively in a team environment.
    • Work independently and deal effectively with stress caused by workload and time deadlines.

     

    Work Environment

    Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.

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