Production Support Engineer (Claims, EDI)

Production Support Engineer (Claims, EDI)

We are seeking an experienced Production Support professional with 5+ years of experience to support mission-critical production systems within a federal claims processing environment. This role is responsible for ensuring stability, performance, and continuous improvement of applications supporting claims vouchering, adjudication, and EDI processing.

The ideal candidate will provide:
- Ensure successful execution of batch jobs and workflows; respond to alerts and system issues.
- Diagnose, troubleshoot, and resolve job failures (abends), including restarting production and test jobs.
- Provide Tier 1/L1 support for production applications and tenant systems.

Incident Management & Issue Resolution
- Perform end-to-end incident lifecycle management including triage, analysis, resolution, and closure
- Conduct root cause analysis (RCA) and identify recurring incident patterns
- Document incidents, escalations, and resolutions in tracking tools (e.g., ServiceNow, SharePoint, Salesforce)
- Collaborate with development, QA, and infrastructure teams for issue resolution

Data Analysis & EDI Processing
- Analyze and process EDI 837/835 healthcare claims and XML files
- Investigate claim errors (e.g., 999 rejections) and ensure data integrity
- Write and execute complex SQL queries across multi-database (Oracle) environments

Documentation & Continuous Improvement
- Develop and maintain SOPs, runbooks, and system documentation
- Document monitoring design, workflows, and support processes
- Contribute to continuous improvement initiatives and operational efficiency

Required Skills

Required Skills & Qualifications
- Bachelors degree in computer science, IT, or related field (or equivalent experience)
- 5-7+ years of experience in IT production support or operations, specifically supporting Claims and EDI systems
- Experience with CA-7 job scheduling and batch processing
- Strong analytical, troubleshooting, and problem-solving skills
- Proficiency in SQL queries, able to run SQL statements, etc.
- EDI 837 transactions is mandatory (835 is a plus), XML processing
- Experience with incident management processes and tools - ServiceNow is required, other tools welcomed.
- Knowledge of Claims Adjudication processes (Healthcare domain)
- Experience with EDI transaction standards and healthcare claims systems
- Exposure to object-oriented programming languages
- Experience working with Blue Cross Blue Shield (BCBS) or similar plans is required
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Technical Skills
- Scripting: Python, Groovy (Jenkins pipelines)
- Monitoring Tools: Dynatrace, Jenkins, Prometheus
- Databases: Oracle, SQL, Snowflakes
- Tools: Jenkins, SharePoint, Salesforce or similar ticketing systems

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