Role : EDI Specialist
Location: Remote
Experience level: 12-15+ Years
Note:
Ø EDI - 834, 835, & 837 & 270, 271, 276, & 277 Hands-on experience required
Ø External client facing experience must & Strong Communication & Tech skills
Ø 60% - Stakeholder/ client management
Ø 40% - Technical experience
• We are 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.
Key Responsibilities:
• ∙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.
Required Skills & Qualifications:
• ∙Bachelor’s 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).
• ∙Hands-on 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.
Preferred Qualifications:
• ∙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.