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 ZealHire Inc.
$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$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$140k - $160k
Senior Integration Engineer, Professional Services... .... We improve healthcare workflows and help... ...will build and support vendor and customer... ...integrations across payers, hospitals, health... ...authorization ecosystems, and you thrive on... ...v2, HL7 FHIR, X12 EDI) and interoperability...EDISeniorTemporary workRemote workFlexible hours$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
- ...Senior Vice President, Payer Sales About the Company Innovative healthcare technology (HealthTech) company Industry Hospital & Health Care Type Privately Held, VC-backed Founded 2011 Employees 201-500 Funding $1-$5 million Specialties...Senior
$69 per hour
...looking for an experienced Senior QA Engineer with strong expertise in healthcare payer systems, TriZetto Facets, and Medicaid managed-care processes... ...programs. Experience supporting Medicaid MCOs or large... ...organizations. Knowledge of healthcare EDI/X12 transactions....EDISeniorH1bLocal area- 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
- ...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
$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$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- ...We're building a new healthcare clearinghouse Stedi is... ...traditional real-time and batch EDI processes, we enable... ...; a lean business team supporting the company's... ...Stedi's relationships with payers, navigating enforcement... ...disputes, ideally while in a senior legal role at a high-...EDI
$130k - $160k
...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 administration...EDIContract workRemote workWork from homeFlexible hoursWeekend work$120k - $200k
...We're building a new healthcare clearinghouse Stedi is building the... ...requires that all insurance payers exchange transactions such as... ...remittances using a standardized EDI format called X12 HIPAA.... ...week out; a lean business team supporting the company’s infrastructure;...EDI- ...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
- ...Medicaid, managed care and commercial payers — then set up the EDI, ERA and EFT connections that let... ...electronically. As a payer enrollment specialist you handle the group side of that... ...tools such as Office Ally, Availity or Change Healthcare. #J-18808-Ljbffr CredSpun LLCEDIWork at office
$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- ...largest health system, and Deerfield Management, a leading healthcare investment firm.Together, we're on a mission to restore... ...customer systems: EHR APIs (Athena, eClinicalWorks, Epic, etc.), payer portals, fax and EDI, document intake, and the rest of the practice's stack....EDIRemote work
- ...Vice President of Sales, EDI & Interoperability... ...payment integrity payer liability payment accuracy... ...recovery healthcare retail pay-for-value... ...with internal teams to support effective service delivery... ...Extensive experience engaging senior health plan decision-...EDIContract work
- ...transactions annually, sourcing data from payer portals, EDI pipelines, and direct connections. Our... ...what those reports leave out. ~ Healthcare data, payer analytics, insurance operations... ...anchors day-one as a data-quality specialist owning a defined slice of the pipeline...EDIImmediate start
- ...footwear & lifestyle brand, is seeking a Senior Operations Manager to oversee day-to-day... ...with cross-functional teams to support the company’s growth. The ideal candidate... ...DTC and wholesale fulfillment, including EDI, routing guides, and retailer compliance...EDISeniorFlexible hours
- ...Computer Science, IT, or related field with 3-4 years of application or production support experience. Hands-on experience with healthcare platforms (HealthEdge, Facets, QNXT) and EDI X12 formats. Strong SQL skills, familiarity with monitoring tools like Dynatrace, and...EDIRemote job
- ...HANA and Cloud, and we offer classes and support through our 50,000+ member community. It’... ...and build modern, resilient integration ecosystems. You thrive in collaborative environments... ...Trading partner management or equivalent EDI Implementation experience.Minimum of 1 end...EDISeniorWork experience placementLive inWork at officeLocal area
- ...Senior Vice President, AI Transformation About the Company... ...media agency focused on the healthcare sector Industry Marketing... ...medical device marketing payer marketing and pharmacoeconomic... ...in AI, large language model ecosystems, agentic systems, and workflow...Senior
$77.2k - $96.5k
...business, Accounting, MIS, Finance, or related field ~3+ years supporting or implementing Oracle EBS R12 and/or Oracle Cloud Financials... ...Familiarity with Oracle Integration Cloud (OIC), REST/SOAP APIs, and EDI processing ~ Experience with Vertex and/or Coupa (preferred)...EDISeniorFull timeShift work$85.47k - $111k
Claims Module Senior Business Analyst About the Role This individual... ...Claim submission - Paper and EDI X12, Adjudication, Payment Cycle... ...with systems like CMdS, GHS, Facets and etc SQL: To validate data... ...the millions of people we support When you join Conduent, you are...EDISeniorRemote workWork from homeFlexible hours- ...of advertising in the healthcare and pharma space? CMI... ...a talented and driven Senior Analyst, Video Investment... ...fast-paced, evolving ecosystem, we want to hear from... ....Key Responsibilities:Support the development of holistic... ...through multi-faceted, cross-channel strategic...Senior
- Job Title: Senior Healthcare Business Analyst / Behavioral Health SME Location... ...+ Years Domain: Healthcare Payer / Behavioral Health... ...payer systems expertise to support payer transformation initiatives... ...with payer platforms such as Facets, QNXT, HealthRules, GuidingCare...SeniorContract workRemote work
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