EDI Developer – Healthcare, NEMT

This is a fully remote position, open to applicants in United States.

📋 Description

• Design, develop, and maintain healthcare EDI pipelines utilizing .NET and EdiFabric

• Parse, validate, generate, and troubleshoot 834 eligibility/enrollment, 837 healthcare claims, 835 remittance advice, 270/271, 999, and 277CA transactions

• Interpret and apply payer-specific companion guides

• Oversee end-to-end claims workflows, encompassing intake, validation, submission, acknowledgments, remittance processing, posting, error handling, corrections, and resubmissions

• Create and sustain logging, auditing, and reconciliation processes

• Collaborate with product teams, operations, health plans, transportation providers, and other external partners

• Ensure compliance with HIPAA regulations for data handling and monitoring

• Contribute to and function within a microservices-based architecture

• Manage EDI workflows from ingestion to reconciliation

⛳️ Requirements

• 5+ years of experience in healthcare EDI development

• Strong expertise in C# / .NET

• Practical experience with EdiFabric in production environments

• In-depth knowledge of healthcare EDI standards and workflows, including X12 structure, loops, segments, and qualifiers

• Demonstrated experience in implementing payer companion guides

• Excellent troubleshooting abilities for payer rejections, inconsistencies, and edge cases

• Solid understanding of HIPAA and secure data handling protocols

• Experience in the NEMT industry is highly preferred

• Familiarity with Medicaid and managed care plans is preferred

• Hands-on experience with Docker, Docker Compose, and Kubernetes is preferred

• Knowledge of GitHub and GitHub Actions (CI/CD pipelines) is preferred

• Exposure to microservices architectures is preferred

• Familiarity with Protobuf / gRPC is preferred

• Experience in deploying and managing backend services in cloud environments is preferred

🏝️ Benefits

• Senior-level ownership and autonomy

• Remote-friendly work environment

• Opportunity to influence the EDI foundation of a growing NEMT platform