Edifecs Developer

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

📋 Description

• Design, develop, configure, and maintain Edifecs applications along with healthcare EDI interfaces.

• Develop and support the processing of HIPAA transactions, such as 834, 835, 837, 270/271, 276/277, and 278.

• Configure and oversee Edifecs modules, including XEngine, SpecBuilder, Transaction Management, and STPM.

• Analyze business needs and convert them into technical solutions.

• Generate mapping specifications and validation rules for both inbound and outbound healthcare transactions.

• Investigate production issues, carry out root cause analysis, and resolve data integration challenges.

• Collaborate with business analysts, product owners, vendors, and operations teams to enhance EDI workflows.

• Assist with unit, integration, regression, and user acceptance testing.

• Ensure adherence to HIPAA regulations and healthcare industry standards.

• Prepare technical documentation, design documents, and support procedures.

⛳️ Requirements

• Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or a related field.

• Minimum of 3 years of Edifecs development experience within a healthcare payer environment.

• Extensive experience with Edifecs XEngine, SpecBuilder, Translator, and STPM.

• Familiarity with HIPAA EDI transactions (834, 835, 837, 270/271, 276/277, 278).

• Proficiency in XML, X12 EDI, SQL, Java, and Web Services.

• Understanding of healthcare claims, enrollment, provider, and eligibility processes.

• Proven experience in troubleshooting production support issues and implementing solutions.

• Strong analytical, problem-solving, and communication abilities.

• Experience with Medicare, Medicaid, and Commercial Health Plans is preferred.

• Knowledge of FHIR APIs and contemporary healthcare interoperability standards is preferred.

• Experience with cloud platforms like Azure or AWS is preferred.

• Background in the healthcare payer or managed care industry is preferred.

• Edifecs certification is preferred.

🏝️ Benefits

• Multiple health and dental plans featuring nationally recognized networks.

• Vision benefits available.

• Comprehensive wellness program.

• Employee assistance program for you and your family.

• Competitive salary structure.

• Retirement savings options.

• Company-covered disability and life insurance.

• Pre-tax savings opportunities (HSA and/or FSA).

• Opportunities for professional development.

• Options for remote work.

• Generous paid-time-off policy.

• Flexible working hours to accommodate vacations, illness, life events, and unforeseen circumstances.