Senior EDI Support Specialist

Position: Senior EDI Support Specialist with Healthcare Payer, Facets

Location: Seattle, WA (Day 1 On-Site)

Long Term

Increase your chances of an interview by reading the following overview of this role before making an application.

Experience: 8+ Years IT | 5+ Years Healthcare Payer & EDI | 3+ Years Edifecs/TriZetto HIPAA Gateway

Mandatory Skills

Healthcare Payer Domain 5+ Years

EDI Development 5+ Years

Edifecs Suite (XEngine, SpecBuilder, TPM, Validation & Compliance) 3+ Years

TriZetto HIPAA Gateway 3+ Years

Facets Required

HIPAA X12 Transactions Strong Hands-on Experience

Trading Partner Integrations Required

EDI Mapping & Validation Required

SQL Server or Oracle Required

Unix/Linux Required

SFTP & Batch Processing Required

API Integrations Required

834 Enrollment Transactions

837 Claims Transactions (P/I/D) Must Have

835 Claims Payment Must Have

270/271 Eligibility Must Have

276/277 Claim Status Must Have

278 Prior Authorization Must Have

820 Premium Payment Must Have

TA1 / 999 / 277CA Acknowledgements Must Have

SQL Server or Oracle Must Have

Unix/Linux Must Have

SFTP & Batch Processing Must Have

XML/XSD & JSON Must Have

Required Skills

Edifecs Suite, TriZetto HIPAA Gateway, BizTalk Server Facets SQL Server/Oracle Unix/Linux SFTP, Batch Processing, API Integrations XML/XSD, JSON

Hands-on support, troubleshooting, and optimization of: 834, 837 (Professional/Institutional/Dental), 835 270/271, 276/277, 278, 820 TA1, 999, and 277CA acknowledgements

Nice to Have

HL7/FHIR ServiceNow MuleSoft, Boomi Groovy, JavaScript, PowerShell, Shell Scripting Blues and large-scale Facets payer environments

Summary:

Seeking a Senior EDI Support Specialist with strong Healthcare Payer experience to provide L2/L3 support for enterprise EDI platforms supporting Claims, Membership, Enrolment, Provider, and Payment functions.

The role requires expertise in HIPAA X12 transaction support, production monitoring, incident resolution, trading partner management, and Edifecs/TriZetto HIPAA Gateway environments.

Responsibilities

• Provide L2/L3 support for EDI platforms supporting Claims, Membership, Enrolment, Billing, Provider, and Payment functions. Monitor, troubleshoot, and resolve EDI transaction failures, rejects, reconciliation, and file transmission issues.
• Support Edifecs, TriZetto HIPAA Gateway, BizTalk, and Facets-integrated environments. Perform RCA, incident resolution, and transaction performance improvements.
• Support trading partner onboarding, certification, testing, and production releases. Work with business users, vendors, and external trading partners to resolve operational issues. xhyhwjd

Preferred: Strong healthcare payer domain knowledge with proven experience supporting large-scale EDI operations, trading partner management, and Facets-integrated ecosystems.