Senior Healthcare Integration Engineer

Title : Senior Healthcare EDI & Integration Engineer
Location : Remote (US-Based)
Job Type : Contract-To-Hire
Compensation : $65 – $70 per hour
Industry: Healthcare Services

Required Skills & Experience:
Senior-level experience supporting healthcare EDI (834, 835, 837, 270/271, 276/277), building and managing FHIR and REST APIs, administering claims platforms, scripting & automating workflows, and supporting secure AWS-based integrations in a HIPAA-regulated environment.

About the Role
Our firm is recruiting a Senior Healthcare EDI & Integration Engineer on behalf of a healthcare services organization that operates as a third-party administrator (TPA) specializing in hearing and ancillary health benefits. The organization supports health plans by managing benefit administration, claims adjudication, eligibility, and member and provider data exchanges.

This role is responsible for leading healthcare data integrations and ensuring the reliability, security, and performance of EDI and API-based data flows that support claims, eligibility, enrollment, and reporting. The position requires deep experience in healthcare EDI, systems administration, automation, and AWS-based infrastructure, as well as the ability to collaborate with internal teams, clients, and external vendors.

Job Description
The Senior Healthcare EDI & Integration Engineer will serve as the technical owner of healthcare integrations and claims platform operations. Responsibilities include implementation, monitoring, troubleshooting, and ongoing support of EDI transactions, APIs, and automation workflows.

Key Responsibilities
Healthcare EDI & Integration

• Lead the assessment, planning, and execution of healthcare EDI implementations, including transactions such as 834, 835, 837, 270/271, and 276/277.
• Gather, analyze, and document technical and business requirements in collaboration with internal stakeholders, clients, and vendors.
• Develop and maintain standards-based interface specifications and implement data interfaces in accordance with business objectives.
• Interpret EDI mapping guides, manage partner communications, and produce operational and technical documentation.
• Publish and maintain FHIR APIs to support modern interoperability requirements.
• Perform monthly member eligibility audits comparing inbound enrollment files to system data and report findings to leadership.

Claims Systems & Platform Administration

• Serve as primary technical owner of claims and eligibility platforms, including file ingestion, transformation, and delivery pipelines.
• Manage user access, security permissions, and system configurations in accordance with compliance and security policies.
• Coordinate operating system patching, updates, and security hardening.
• Monitor and manage daily processing of eligibility, claims, and provider files to ensure accuracy and timeliness.
• Partner with infrastructure teams to ensure system availability, performance, and scalability.

Automation & Scripting

• Design, develop, and maintain automation scripts to support claims processing, eligibility workflows, and client-specific integrations.
• Identify opportunities to reduce manual effort through automation and process optimization.

Client Technical Onboarding

• Lead technical onboarding for new clients, including SFTP configuration, file validation, test file processing, and automation setup.
• Coordinate testing activities in lower environments and maintain test data.
• Collaborate with client technical teams to ensure secure data exchange protocols.

Vendor & Stakeholder Collaboration

• Act as the primary technical contact for clearinghouses and technology vendors.
• Troubleshoot issues across production and non-production environments.
• Work closely with internal claims, operations, finance, and leadership teams to support audits, reporting, and issue resolution.

Monitoring, Support & Incident Management

• Monitor system health, alerts, and file transmissions to ensure uninterrupted operations.
• Manage inbound and outbound EDI jobs, encryptions, transfers, and conversions.
• Troubleshoot EDI, API, and file transfer issues and manage support tickets to resolution.
• Maintain and test SFTP connections.

Audit, Compliance & Documentation

• Support SOC, HIPAA, and internal audits by providing technical evidence and documentation.
• Ensure compliance with HIPAA, data security standards, and internal IT policies.
• Develop and maintain comprehensive technical documentation covering architecture, data flows, and client-specific integrations.

Disaster Recovery & Business Continuity

• Partner with IT leadership to develop and maintain disaster recovery procedures.
• Participate in regular disaster recovery testing and document recovery steps for critical systems.

Qualifications
Required Qualifications:

• 4+ years of experience in IT operations, systems engineering, or integration engineering.
• 2+ years of hands-on healthcare EDI experience within a payer, TPA, or healthcare services organization.
• 2+ years supporting application platforms in a production environment.
• Expertise with EDI transactions, including:
  • 837 (Claims)
  • 835 (Remittance Advice)
  • 834 (Enrollment)
  • 270/271 (Eligibility)
  • 276/277 and 999 (Claim Status and Acknowledgments)
• 2+ years of experience working with AWS infrastructure, including S3, Transfer Family, Lambda, and SFTP configurations.
• Experience managing and publishing FHIR APIs with a strong understanding of FHIR standards and profiles.
• Experience developing or supporting RESTful APIs using languages such as Python, Java, or .NET.
• Proficiency in scripting and automation using languages such as Python, PowerShell, or Bash.
• Experience with secure file transfer protocols and healthcare data exchange standards.
• Familiarity with healthcare clearinghouses and claims staging processes.
• Working knowledge of Windows and Linux operating systems.
• Strong troubleshooting, analytical, and problem-solving skills.
• Excellent written and verbal communication skills, including the ability to explain technical concepts to non-technical stakeholders.
• Knowledge of HIPAA regulations and secure handling of protected health information (PHI).
• Ability to manage multiple priorities with limited direction.

Preferred Qualifications:

• Experience supporting healthcare payer or third-party administrator systems.
• Experience supporting SOC, HIPAA, or internal IT audits.
• Familiarity with claims adjudication workflows and benefits administration platforms.
• Experience collaborating closely with external vendors and client technical teams.

Benefits
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family’s needs. For details, please review the DAHL Benefits Summary:  How to Apply
Take the first step on your new career path!  To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we’ve reviewed your application details, a recruiter will reach out to you with next steps!
Equal Opportunity Statement
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!

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