Senior EDI Support Specialist (Healthcare Payer | Facets Ecosystem)
ZealHire Inc.
Senior EDI Support Specialist (Healthcare Payer | Facets Ecosystem) | JPC-8957 Senior EDI Support Specialist (Healthcare Payer | Facets Ecosystem) Location: Remote USC, GC, H4-EAD, Gc-EAd 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 Strong healthcare payer domain knowledge with proven experience supporting large-scale EDI operations, trading partner management, and Facets-integrated ecosystems. $000,000 – $000,000 Salary range is not shown on the candidate portal #J-18808-Ljbffr
$60 per hour
...Start/End Dates: 10/28/2026 - 12/31/2026 Tax Work Location: USA-Working from Home Bill rate: $60 pr hr Ensure on time delivery and support to meet client requirements on product/project specifications. Manage team activities and ensure readiness of the support echo system...EDISeniorWork from home- ...seeking a remote-based contractor to ensure on-time delivery and to support client requirements on product and project specifications. You... ...manage team activities and ensure readiness of the support ecosystem for customers, collaborating with product engineers to address...EDISeniorFor contractorsRemote work
- ...Job Description At least 7-8 years healthcare experience Experienced in Facets testing different modules Member Enrollment and Eligibility, Claim Processing... ...execution Well versed in Health Care with HIPPA, EDI and x12 data formats Additional Information Note...EDIH1b
- ...HealthEdge is seeking a Test Lead II with healthcare payer domain expertise to drive test planning and execution for payer system engagements... ...detailed test cases for claims processing, enrollment, benefits, and EDI transactions, lead various test cycles, analyze requirements,...EDIRemote work
- ...seeking an Edifecs Electronic Data Interchange (EDI) Analyst Transaction Specialist for a remote, full-time role supporting Veterans Affairs. The ideal candidate has 8+... ...experience and expertise in SNIP compliance, X.12, and payer/provider workflows. Responsibilities include...EDIFull timeRemote work
- ...Manager / Senior Manager - Full Stack Development (Healthcare) Location: Remote (United States) Tech Stack: Distributed... ...expertise in the US health insurance or payer space: claims, enrollment,... ...interoperability standards (HL7, FHIR, X12 EDI) applied across large-scale...EDISeniorRemote work
- ...Role: Business Systems Analyst (Healthcare Payer/Member Domain) Experience: 10 years Location: Remote... ...& Gap Analysis Data Analysis UAT Support Stakeholder Management Technical Skills... ...SQL Data Mapping API & Interface Analysis EDI Transactions Key Responsibilities Gather...EDIRemote work
$265.2k - $331.5k
...this by building a new mental healthcare system everyone can access. We... ...of financial logic. A senior high-leverage platform role at... ...the provider is paid what the payer is billed and whether all three... ...experience; healthcare billing or EDI exposure; fintech or payments...EDISeniorFull timeWork from homeFlexible hours$90k - $120k
...and shape the future of healthcare technology. Learn more... ...Lead II with healthcare payer domain expertise to... ...benefits, provider data, and EDI transaction flows Lead... ...and X12 standards Support compliance and regulatory... ...2+ years in a lead or senior tester role Solid experience...EDIRemote work$77k - $202k
...Description & SummaryThe OpportunityAs a Payer Back Office Strategy / Technology / Operations Consultant, Senior Associate you will support healthcare payer clients as they modernize back-... ...and systems such as Oracle OHI, Epic, Facets, and Nasco.Responsibilities- Analyzing...SeniorFull timeH1b- ...practice partners with payer, provider,... ...operations, improve healthcare experiences, and responsibly... ...have experience supporting or leading... ...provider operations, EHR ecosystems, pharmacy... ...APIs, FHIR, HL7, EDI, secure data exchange... ...platforms such as Facets, QNXT, HealthRules...EDIWork experience placementLive inWork at officeLocal area
- ...industry expertise, and leading ecosystem relationships to deliver end-... ...technology programs for our healthcare clients. You are a proven... ...leader who combines strong health payer industry knowledge,... ...building trusted relationships with senior client executives.As an Accenture...SeniorWork experience placementLive inWork at officeLocal area
$80k - $90k
...provide far greater access to jobs, healthcare, and education. Our platform... ...efficient digital networks. As Via’s Senior Benefits Specialist , you will be supporting the strategy, administration and... ..., auditing carrier integrations (EDI feeds). Act as a point of...EDISeniorLocal areaFlexible hours$94.4k - $266.3k
...practice partners with payer, provider,... ...operations, improve healthcare experiences, and responsibly... ...have experience supporting or leading... ...provider operations, EHR ecosystems, pharmacy... ...APIs, FHIR, HL7, EDI, secure data exchange... ...platforms such as Facets, QNXT, HealthRules...EDIWork experience placementLive inWork at officeLocal area$132.5k - $302.4k
...industry expertise, and leading ecosystem relationships to deliver end-... ...technology programs for our healthcare clients. You are a proven... ...leader who combines strong health payer industry knowledge,... ...building trusted relationships with senior client executives. As an...SeniorWork experience placementLive inWork at officeLocal area$85k - $95k
...community of experts who support your growth, career aspirations... ...overview Health Payer Specialist, a Financial Times Specialist... ...publication, is looking for a Senior Reporter to cover one of... ...reporting on the healthcare or payer ecosystem, or have developed deep expertise...SeniorFull timeWork at officeWorldwideFlexible hours- ...alternative application process. Sr. Healthcare Business Analyst/Quality... ...unparalleled service and support while providing innovative,... .... Job Description: The Senior Healthcare Business and... ...standards such as HL7, FHIR, X12 EDI, code sets, and payer or provider data exchanges...EDISeniorFull timeWork at officeLocal areaRemote work
- Covet Health Inc. is hiring a claims processor/examiner with 4+ years of healthcare payer experience. The role focuses on day-to-day claims processing, adjudication, and research to verify coverage and medical necessity under policy guidelines. You will work in a hybrid...Senior
- ...Our client seeks a Sr. Data Production Support Systems Specialist to support data, reporting,... ...solutions, SQL-based applications, and EDI processes. Support business intelligence... ...across functional teams and operate as a senior, hands-on individual contributor. xmvmafu...EDISeniorContract work
$77k - $202k
...Risk & Compliance - Health Industries - Payer Compliance - Senior Associate you will help clients... ...build meaningful client connections, and support junior team members while developing... ...support remediation planning- Interpreting healthcare regulatory developments and applying...SeniorFull timeH1b- ...Conduent seeks a Claims Module Senior Business Analyst to lead the Claims Domain for MMIS health care projects. You will drive the claims... ...requires strong Medicaid/Medicare knowledge, hands-on claims processing, and experience with EDI X12 formats. #J-18808-Ljbffr...EDISeniorRemote work
- ...connects the fragmented healthcare data ecosystem for more efficient... ...modern health plan. Payers, third-party administrators... ...stakeholders. Relay supports multiple data... ...delivery reporting to senior client stakeholders.... ...processing, healthcare EDI, or health plan administrationExperience...EDIContract work
- ...Lead Edifecs Analyst to lead healthcare EDI integration initiatives for a... ...transactions, and healthcare payer systems. Key Responsibilities... ..., and Oracle databases to support healthcare EDI integration platforms... ...platforms such as Facets, QNXT, and HealthRules. Ensure...EDIRemote work
$98k - $115k
...on a mission to make healthcare work for all of us. Through... ...go-live. The Client Support Team focuses on... ...team reporting to the Senior Manager of Client Support... ...obsessed Client Support Specialist to join a fast-paced team... ...family health. Prior payer-side experience at a...SeniorFull timeContract workWork at officeImmediate startRemote workFlexible hours3 days per week$77k - $202k
...SummaryThe OpportunityAs a Health Actuary Consultant- Payer/Provider- Senior Associate you will contribute to strategic, analytic, and technical support for payer and provider clients as they respond to a changing healthcare market and work to maintain margin and manage...SeniorFull timeH1b- HonorHealth is seeking a Remote Billing Specialist in the Phoenix metro area. You will bill and file all claims for UBs and... ...Responsibilities include daily claim submission, AR benchmarking, EDI processing, and updating payer files. The role requires hospital billing experience and...EDISeniorRemote job
$45.36k - $62.37k
Senior Supplier Quality Support Specialist### Senior Supplier Quality Support SpecialistApply: Remote: Remote - Georgia: CA, MANITOBA, VIRTUAL: Full time... ...: R01134055At Solventum, we improve lives by helping healthcare professionals do their best work. Join a team using...SeniorFull timeH1bWork at officeRemote workRelocation packageFlexible hours- ...longitudinal care that supports women through every... ..., Allara makes expert healthcare accessible by connecting... ...women. The Opportunity Payer Operations is one of... ...claim gets paid. As our Senior Manager of... ...based and international specialists. Set clear expectations...SeniorFull timeContract workWork at office3 days per week
$113.01k - $202.16k
...discovery. To achieve these aims, we support a cutting-edge high-performance computing and data ecosystem along with MD/PhD-level... ...services team.ResponsibilitiesThe Senior HPC Administrator, High... ...impact area of responsibility; healthcare technology experience preferred...SeniorTraineeshipLocal area$103k - $153k
...brutThe opportunityWe are seeking a Senior Software Developer, based either in... ...for delivering Unity platform support for an Android-based ecosystem encompassing mobile, laptop, and hybrid... ...like automotive, manufacturing, and healthcare to design, simulate, and...SeniorFull timeTemporary workWork at officeRemote workWorldwide
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