Job Description

Role : EDI Subject Matter Expert (SME)

Location : Remote

Job Type : Contract

We're seeking an EDI Subject Matter Expert (SME) with hands-on experience in CMS enrollment reconciliation (RCNI/RCNO, Pre-Audit, 834) to support a six-week consulting engagement. The role involves assessing current reconciliation processes, identifying root cause issues, and producing workflow/process documentation to guide long-term improvementsIf you have strong CMS exchange and ACA enrollment expertise, we'd like to connect.

Can you please have your candidates answer the following questions:

1. Please walk me through your hands-on experience with the RCNI/RCNO reconciliation process from start to finish. Please include which tools or platforms (e.g., Edifecs, Sterling, SQL, Excel) you've used to support this work.(If you have any examples of your work that you can share that would be greatly appreciated.)
2. Have you ever served as a subject matter expert or trainer on the RCNI/RCNO process? If so, how did you help your team or organization improve accuracy, efficiency, or understanding of CMS reconciliation requirements?
3. When you identify recurring issues in RCNI/RCNO reconciliation (such as mismatched 834 data or persistent CMS rejections), how do you approach root cause analysis and ensure long-term process improvements rather than one-time fixes?

Email- [email protected] Phone Number : +1 321 7856 062

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