Sr. Java Health Plans EDI Specialist
Benecard Services, Inc., Clifton, NJ, United States
We are seeking an experienced Java Developer to support the development, maintenance, and enhancement of electronic data interfaces and CMS government reporting processes. This role is critical to ensuring accurate, compliant data exchange within a managed care / healthcare insurance environment.
The ideal candidate brings strong hands-on experience with Java, SQL, HIPAA EDI transactions, APIs, and CMS encounter data submissions, along with the ability to troubleshoot production issues and support mission-critical systems.
This is a fully onsite position (5 days per week).
Key Responsibilities
Maintain and enhance automated data interfaces using standard HIPAA EDI formats and custom file layouts for eligibility and claims processing
Support processes related to encounter data submissions to contracted health plans
Monitor, reconcile, and validate submitted encounters against response files to ensure timely resolution of errors
Develop and maintain processes to generate CMS-required data universes and reports
Create customized reports for internal stakeholders and external clients
Troubleshoot and resolve production issues across multiple interfaces and applications
Prepare and maintain technical documentation for applications and data interfaces
Provide off-hours support as required
Required Qualifications
Professional experience with HIPAA EDI transactions (837, 277, 835, 834, etc.)
Hands-on experience designing, developing, and maintaining APIs
Proven experience with CMS and DHS reporting requirements, formats, and encounter submissions
Experience with EDI translation software (iWay experience strongly preferred)
Familiarity with managed care health programs and the healthcare insurance industry
Strong expertise in Java application development, including designing, coding, testing, debugging, documenting, and supporting production systems
Advanced knowledge of Java, SQL, XML, JDBC, and SFTP
Experience with database platforms such as DB2 and MySQL
Proficiency in Microsoft Excel, including working with large datasets and standardized reporting
Working knowledge of Microsoft Office (Excel, Word, Access)
Experience in an AS/400 environment
Working knowledge of COBOL is a plus
Desired Attributes
Strong ability to analyze existing code and implement effective enhancements
Ability to work independently and collaboratively within a team environment
Self-directed with excellent time-management and organizational skills
Highly detail-oriented with a strong commitment to data accuracy
Clear, professional, and effective communication style
Positive attitude and a good sense of humor
Featured Benefits
Competitive salary
Vacation and Sick/Personal Time
Medical Insurance
Hearing Program Discount
Short- and Long-Term Disability Insurance
Life Insurance
Flexible Spending Account
401(k)
Employee Referral Program
Employee Recognition Programs
Tuition Reimbursement
Professional Development and Training
Benecard Services, LLC
Benecard Services, LLC has been administering carve-out, fixed rate insured prescription drug benefit programs since 1990. Benecard is a full service, in-house prescription benefit administrator that includes mail and specialty drug dispensing. We are a premiere nationwide Prescription Benefit Administrator headquartered in Lawrenceville, New Jersey.
Website: http://www.benecard.com
BeneCard PBF
BeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace. Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care. Headquartered in Bonita Springs, Florida.
Website: http://benecardpbf.com
National Vision Administrators
For over 40 years, National Vision Administrators (NVA) has been meeting the vision benefit needs of public employer groups, Health & Welfare Funds, Associations and Coalitions. Providing millions of people throughout the United States with vision care programs that help them be smarter buyers of eye care and eyewear, NVA is particularly well suited to address today's health benefit challenges as it relates to eye care. We offer cost-effective, customized vision benefit programs that are clinically integrated. We are proud of the fact that we have retained over 99% of our clients and believe it is the greatest testimony to the high-quality benefits and service satisfaction we provide to both our clients and their members. Headquartered in Clifton, New Jersey.
Website: http://www.e-nva.com
We are an Equal Opportunity employer.
The ideal candidate brings strong hands-on experience with Java, SQL, HIPAA EDI transactions, APIs, and CMS encounter data submissions, along with the ability to troubleshoot production issues and support mission-critical systems.
This is a fully onsite position (5 days per week).
Key Responsibilities
Maintain and enhance automated data interfaces using standard HIPAA EDI formats and custom file layouts for eligibility and claims processing
Support processes related to encounter data submissions to contracted health plans
Monitor, reconcile, and validate submitted encounters against response files to ensure timely resolution of errors
Develop and maintain processes to generate CMS-required data universes and reports
Create customized reports for internal stakeholders and external clients
Troubleshoot and resolve production issues across multiple interfaces and applications
Prepare and maintain technical documentation for applications and data interfaces
Provide off-hours support as required
Required Qualifications
Professional experience with HIPAA EDI transactions (837, 277, 835, 834, etc.)
Hands-on experience designing, developing, and maintaining APIs
Proven experience with CMS and DHS reporting requirements, formats, and encounter submissions
Experience with EDI translation software (iWay experience strongly preferred)
Familiarity with managed care health programs and the healthcare insurance industry
Strong expertise in Java application development, including designing, coding, testing, debugging, documenting, and supporting production systems
Advanced knowledge of Java, SQL, XML, JDBC, and SFTP
Experience with database platforms such as DB2 and MySQL
Proficiency in Microsoft Excel, including working with large datasets and standardized reporting
Working knowledge of Microsoft Office (Excel, Word, Access)
Experience in an AS/400 environment
Working knowledge of COBOL is a plus
Desired Attributes
Strong ability to analyze existing code and implement effective enhancements
Ability to work independently and collaboratively within a team environment
Self-directed with excellent time-management and organizational skills
Highly detail-oriented with a strong commitment to data accuracy
Clear, professional, and effective communication style
Positive attitude and a good sense of humor
Featured Benefits
Competitive salary
Vacation and Sick/Personal Time
Medical Insurance
Hearing Program Discount
Short- and Long-Term Disability Insurance
Life Insurance
Flexible Spending Account
401(k)
Employee Referral Program
Employee Recognition Programs
Tuition Reimbursement
Professional Development and Training
Benecard Services, LLC
Benecard Services, LLC has been administering carve-out, fixed rate insured prescription drug benefit programs since 1990. Benecard is a full service, in-house prescription benefit administrator that includes mail and specialty drug dispensing. We are a premiere nationwide Prescription Benefit Administrator headquartered in Lawrenceville, New Jersey.
Website: http://www.benecard.com
BeneCard PBF
BeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace. Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care. Headquartered in Bonita Springs, Florida.
Website: http://benecardpbf.com
National Vision Administrators
For over 40 years, National Vision Administrators (NVA) has been meeting the vision benefit needs of public employer groups, Health & Welfare Funds, Associations and Coalitions. Providing millions of people throughout the United States with vision care programs that help them be smarter buyers of eye care and eyewear, NVA is particularly well suited to address today's health benefit challenges as it relates to eye care. We offer cost-effective, customized vision benefit programs that are clinically integrated. We are proud of the fact that we have retained over 99% of our clients and believe it is the greatest testimony to the high-quality benefits and service satisfaction we provide to both our clients and their members. Headquartered in Clifton, New Jersey.
Website: http://www.e-nva.com
We are an Equal Opportunity employer.