EDI Developer

Senior EDI Developer

Healthcare Payer | Facets Ecosystem

Experience: 8+ Years IT | 5+ Years Healthcare Payer & EDI | 3+ Years Edifecs/TriZetto HIPAA Gateway

Duration : Towards the end of year with possible extension.

REMOTE ROLE

NOTE: Must have facets with claims experience and also on Claims, Membership, Enrolment, Billing, Provider, and Payment.

Summary

Seeking 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, Enrolment, Provider and Payment domains.

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, Enrolment, Provider, and Payment domains.
• Perform EDI map optimization 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
• BizTalk Server
• Facets
• SQL Server/Oracle
• Unix/Linux
• SFTP, Batch Processing, API Integrations
• XML/XSD, JSON

Required Experience

Hands-on development and optimization of:

• 834
• 837 (Professional/Institutional/Dental)
• 835
• 270/271
• 276/277
• 278
• 820
• TA1
• 999
• 277CA acknowledgements

Nice to Have

• HL7/FHIR
• MuleSoft, Boomi
• Groovy, JavaScript, PowerShell, Shell Scripting
• Blues experience

Job Description

Expectations from this role

Independently develops error free code with high quality validation of applications, guides other developers and assists Lead 1 Software Engineering

1. Understand and provide input to the application/feature/component designs; developing the same in accordance with user stories/requirements.
2. Code, debug, test, document and communicate product/component/features at development stages.
3. Select appropriate technical options for development such as reusing, improving or reconfiguration of existing components.
4. Optimize efficiency, cost and quality by identifying opportunities for automation/process improvements and agile delivery models.
5. Identify the problem patterns and improve the technical design of the application/system.
6. Proactively identify issues/defects/flaws in module/requirement implementation.
7. Assists Lead 1 Software Engineering on Technical design. Review activities and begin demonstrating Lead 1 capabilities in making technical decisions.

Education/Experience Requirements

• Graduate in Engineering or MCA/Equivalent with 3 years of Software Engineering experience.
• Graduate in Science/Commerce or BCA/Equivalent with 4 years of Software Engineering experience.