Principal Technology Architect - Insurance Claims, Encounters & Policy Administration) - 67412

Principal Technology Architect Insurance (Claims, Encounters & Policy Administration) 67412

Pay Rate: $50 -$55/hr

We have an urgent need for a Principal Technology Architect Insurance (Claims & Policy Administration) based in Richardson, TX 75081, USA. This is a long-term contract role requiring a senior, client-facing professional who can work onsite, interact directly with stakeholders, and support enterprise healthcare and insurance initiatives in a complex delivery environment.

In this role, you will act as a senior Business/Technology Architect with deep expertise in encounters and claims management, working closely with client teams to drive solution design, analysis, and delivery. You will be responsible for translating business requirements into technical and functional solutions, mentoring team members, and engaging with the client on a regular basis to ensure alignment and delivery quality. The role involves hands-on work with healthcare EDI transactions, source-to-target mapping, transformation rules, and encounter management, along with contributing to strategic discussions and guiding best practices across the engagement. The position supports large-scale insurance platforms and cloud-enabled deployments, including environments used by Client

The ideal candidate will bring strong BA experience in encounters and claims management with very strong SQL skills. Deep hands-on knowledge of the EDIFECS platform, including Spec Builder, Application Manager, Transaction Manager, MAPs, Profilers, and deployment concepts, is required. You should have a detailed understanding of healthcare EDI transactions 834, 835, and 837, including loops, segments, and key attributes, along with experience in defining custom rules, validations, and transformations. Familiarity with Edifecs Enrollment Management, merging and splitting EDI files, Groovy scripting, and cloud platforms such as AWS is highly desirable. Strong domain knowledge of enrollment, plan, and group setup rules, along with the ability to mentor teams and lead client interactions, is essential for success in this role.

Interested candidates are requested to connect with our recruiter

Bhagya
PRIMUS Global Services
Desk Ext. 202
Email: