EDI Specialist
EDI Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
The ideal candidate should have:
- Proven expertise in EDI transactions and integrations
- Hands-on experience working in client and vendor-facing roles
- Solid understanding of healthcare standards and compliance requirements
- Excellent communication and stakeholder management skills
- seeking a skilled Integration Developer with strong Electronic Data Interchange (EDI) expertise and a solid understanding of healthcare domain standards to design develop and maintain integration solutions.
- This role will focus on implementing testing and supporting EDI transactions ensuring compliance with HIPAA and healthcare industry standards.
- Design develop and maintain integration solutions for healthcare data exchange using EDI standards (e.g. X12 HL7).
- Implement configure and support EDI transactions such as 837 (claims) 835 (remittance) 270/271 (eligibility) 276/277 (claim status).
- Work with healthcare partners payers and providers to troubleshoot and resolve integration issues.
- Develop mapping translation and transformation processes between internal systems and external partners.
- Ensure compliance with HIPAA security protocols and industry data exchange requirements.
- Collaborate with business analysts QA teams and project managers to gather requirements and deliver high-quality integration solutions.
- Monitor integration processes and proactively identify performance or data issues.
- Maintain detailed technical documentation and provide training or knowledge transfer to internal teams.
- Bachelors degree in Computer Science Information Technology or related field (or equivalent experience).
- 5 years of experience in integration development with a strong focus on EDI in the healthcare industry.
- Proficiency in healthcare EDI standards (HIPAA X12 HL7).
- Handson experience with integration tools (e.g. MuleSoft Dell Boomi Cloverleaf IBM Sterling integrator BizTalk or similar).
- Strong knowledge of healthcare processes including claims eligibility payments and prior authorizations.
- Solid understanding of XML JSON SQL REST and SOAP-based web services.
- Strong troubleshooting and problem-solving skills.
- Excellent communication and collaboration abilities.
- Experience with cloud-based integration platforms (e.g. Azure Logic Apps AWS Step
- Functions or GCP integrations).
- Knowledge of FHIR (Fast Healthcare Interoperability Resources) standards.
- Previous work with payer or provider systems.
- Familiarity with agile development methodologies.
Employment Type
Full-time
