EDI Specialist
- USA
- Permanent
- Full-time
- 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,
- 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.
- 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.
- 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