Senior EDI Support Specialist
Sumeru Solutions
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.
Required Skills
- Edifecs Suite
- TriZetto HIPAA Gateway
- BizTalk Server
- Facets
- SQL Server/Oracle
- Unix/Linux
- SFTP, Batch Processing
- API Integrations
- XML/XSD, JSON
Required Experience
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
Preferred: Strong healthcare payer domain knowledge with proven experience supporting large-scale EDI operations, trading partner management, and Facets-integrated ecosystems.
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