EDI Data Engineer / Remote

Job Description

Job Title: Data Engineer - EDI & Claims - NYC - Remote

Salary Range: Up to $130,000 per year

Location: New York, NY

Position Summary
We are seeking an experienced Data Engineer with strong healthcare EDI and claims expertise to support critical health plan operations. This role will serve as a subject matter expert for EDI X12 transactions, encounter submissions, healthcare claims, enrollment, and membership data processes. The position plays a key role in ensuring data accuracy, regulatory compliance, and operational efficiency while collaborating across internal teams and vendor partners to improve healthcare delivery outcomes.
This is a hybrid position requiring two days onsite weekly in the NYC office.

Responsibilities
• Schedule / Shift

• Remote Role, Full-Time Monday through Friday, 9am to 5pm EST, Permanent Position

• Key Duties

• Manage and optimize encounter data submissions to state and federal agencies
• Troubleshoot EDI X12 mapping issues and resolve data transmission challenges
• Develop, maintain, and optimize SQL queries, stored procedures, and SSIS jobs
• Collaborate with internal stakeholders and vendors to resolve healthcare data integration issues
• Support compliance and operational teams with timely reporting and data analysis
• Build data quality controls and document workflows to improve accuracy and efficiency
• Support MMCOR reporting activities and KPI dashboard development
• Maintain compliance with healthcare regulatory and reporting requirements

Requirements
• Education

• Required: Bachelor's Degree in Information Systems, Computer Science, Healthcare Informatics, or related field

• Experience

• 5+ years SQL Server experience including Stored Procedures, SSIS, and SSRS
• 3+ years healthcare data experience including claims, enrollment, provider, and membership data
• Strong knowledge of EDI X12 standards and healthcare transaction file mapping
• Experience working with healthcare claims and encounter submission processes
• Healthcare payer or health insurance experience strongly preferred

• Required Skills

• Extensive EDI X12 submissions and standards experience ( must have - accounts for approximately 70% of role responsibilities )
• Strong healthcare claims data knowledge
• Experience with Business Intelligence tools including Tableau, Power BI, or BusinessObjects
• Ability to troubleshoot complex healthcare data workflows and integrations
• Strong communication, documentation, and collaboration skills

• Preferred / Bonus Skills

• Visual Studio
• .NET
• XML
• BizTalk

Work Authorization Requirement
Applicants must be legally authorized to work in the United States at the time of hire. This position is available to candidates who can work on a W-2 basis only. Sponsorship, C2C, and OPT are not available.

About This Opportunity
For over 30 years, this mission-driven healthcare organization has focused on improving healthcare outcomes for New Yorkers through innovation, collaboration, and operational excellence. Employees enjoy competitive compensation, strong benefits, pension offerings, career growth opportunities, and the ability to make a meaningful impact on healthcare delivery.

About Us
RCM Healthcare Services works with professionals across schools, healthcare, and community-based settings nationwide. We support both contract and direct hire opportunities, connecting people early in their careers and experienced professionals to roles that align with their experience and preferences. With more than 50 years of staffing experience, our team understands the environments professionals are stepping into and what it takes to be successful in them. We stay closely involved from first conversation through placement, providing consistent communication and support throughout the hiring process.

Equal Employment Opportunity & Reasonable Accommodation
RCM Technologies is an equal opportunity employer and values diversity. We are committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state laws. If you require a reasonable accommodation to apply for or perform this role, please contact us so we can support your needs.


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