EDI DEVELOPERnbsp
EDI DEVELOPERnbsp
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Job Description
Job title EDI DEVELOPER
Remote
VISA NO OPT AND H1b
We are looking for an experienced Healthcare EDI Developer to join our dynamic team. The ideal candidate will possess strong expertise in implementing managing and supporting EDI transactions specific to the healthcare domain. You will play a key role in ensuring the seamless exchange of healthcare data optimizing processes and maintaining compliance with industry standards such as HIPAA.
Key Responsibilities:
- Develop implement and maintain EDI solutions that support healthcarerelated transactions.
- Work with stakeholders to map and define EDI processes in accordance with business needs.
- Ensure the successful processing of healthcare EDI transactions including but not limited to:
- 834: Benefit Enrollment and Maintenance
- 837: Health Care Claims (Professional Institutional and Dental)
- 270/271: Eligibility Coverage or Benefit Inquiry and Response
- 276/277: Health Care Claim Status Request and Response
- 835: Health Care Claim Payment/Remittance Advice
- 820: Health Insurance Premium Payment
- 275: Patient Information
- 278: Health Care Services Review
- Collaborate internal teams to resolve transaction issues and ensure data accuracy.
- Conduct regular testing validation and troubleshooting of EDI systems to meet regulatory and operational requirements.
- Monitor transaction activity to ensure the integrity of EDI processing.
- Prepare and maintain technical documentation for all processes and system integrations.
- Ensure compliance with HIPAA standards and other regulatory guidelines.
- Participate in system upgrades migration and EDI enhancements.
Required Skills and Qualifications:
- 5 years of experience in EDI development particularly in the healthcare domain.
- Strong knowledge of healthcare EDI transactions (/271 276/).
- Experience with EDI mapping tools and translators (e.g. Sterling Integrator Gentran BizTalk etc.).
- Proficiency in EDI formats including X12 and HL7.
- Solid understanding of HIPAA requirements and data privacy regulations.
- Experience in working with various healthcare organizations payers providers and clearinghouses.
- Strong problemsolving skills and ability to troubleshoot EDI processing errors.
- Familiarity with databases (SQL Oracle) and scripting for EDI process automation.
- Excellent communication skills with the ability to collaborate effectively with crossfunctional teams.
Preferred Qualifications:
- Experience in managing EDI implementations in a cloudbased environment.
- Knowledge of healthcare industry standards and workflows.
Prior experience in EDI modernization projects.
Employment Type
Full Time
