Senior EDI Developer (Healthcare Payer - Facets Ecosystem)

Saransh Inc

Washington DC

Role: Senior EDI Developer: Healthcare Payer (Facets Ecosystem)

Location: Seattle, WA (Onsite from Day 1)

Job Type: Contract

Experience:

8+ years in IT, 5+ years in healthcare payer and EDI, 3+ years with Edifecs or TriZetto HIPAA Gateway
Need candidates with Facets - Claims experience

Role Overview:

We are looking for a Senior EDI Developer with strong healthcare payer experience to design, develop, and optimize HIPAA X12 integrations within a Facets-based ecosystem.
The role requires hands-on expertise in Edifecs/TriZetto HIPAA Gateway, EDI mapping, trading partner integrations, and high-volume transaction processing across Claims, Membership, Enrollment, Provider, and Payment domains.

Key Responsibilities:

Design, develop, and optimize EDI solutions using Edifecs, TriZetto HIPAA Gateway, BizTalk, or equivalent platforms.
Develop EDI mappings, validations, routing logic, and trading partner integrations.
Implement and support HIPAA X12 transactions across Claims, Membership, Enrollment, Provider, and Payment domains.
Optimize EDI maps and support high-volume transaction processing.
Support trading partner onboarding, testing, certification, and production deployments.
Collaborate with Facets and business teams to deliver EDI enhancements and integrations.

Required Skills:

Edifecs Suite: XEngine, SpecBuilder, Trading Partner Management, Validation & Compliance
TriZetto HIPAA Gateway and BizTalk Server
Facets
SQL Server / Oracle
Unix/Linux
SFTP, batch processing, and API integrations
XML/XSD and JSON

Required Experience:

Hands-on development and optimization of the following transactions:

834 (Enrollment)
837 (Professional, Institutional, Dental)
835 (Remittance)
270/271 (Eligibility)
276/277 (Claim Status)
278 (Authorization)
820 (Premium Payment)
TA1, 999, and 277CA acknowledgements

Nice to Have:

HL7 / FHIR
MuleSoft or Boomi
Groovy, JavaScript, PowerShell, or shell scripting
Blues plan experience

Apply

Vacancy posted 2 days ago

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