Must Have Technical/Functional Skill
Design, develop, and maintain Edifecs based EDI solutions supporting healthcare transactions in payer, provider, and clearinghouse environments.
Build and manage EDI mappings, transactions, and workflows using Edifecs tools and frameworks.
Develop, configure, and support HIPAA compliant X12 EDI transactions, ensuring accuracy, reliability, and regulatory adherence.
Work hands on with Edifecs implementations, including configuration, customization, deployment, and ongoing support.
Perform EDI mapping development and enhancements, ensuring correct transformation between internal systems and external trading partners.
Support multiple healthcare EDI transaction types (e.g., claims, eligibility, remittance, enrollment, acknowledgements).
Ensure strict compliance with HIPAA, healthcare regulatory standards, and data privacy requirements.
Participate in testing activities, including unit testing, integration testing, regression testing, and UAT support.
Support EDI migrations, upgrades, trading partner onboarding, and platform transitions.
Analyze EDI errors, transaction rejections, and data issues; perform root cause analysis and resolution.
Collaborate with business analysts, healthcare SMEs, and integration teams to understand transaction requirements.
Support production issues and defect fixes, ensuring timely resolution and minimal business impact.
Maintain documentation for mappings, transaction flows, and integration specifications.
Work effectively in an Agile delivery model, executing assigned stories and integration tasks.
Ensure high delivery quality, accuracy, and reliability for healthcare data exchanges.
Roles & Responsibilities
Design and implement EDI mappings and workflows using Edifecs.
Develop and support Edifecs implementations for healthcare data exchange.
Configure and maintain X12 transactions, ensuring compliance with HIPAA standards.
Support healthcare integrations between internal systems, trading partners, and clearinghouses.
Perform EDI testing, validation, and troubleshooting across development and test environments.
Assist in EDI migrations, upgrades, and onboarding of new trading partners.
Analyze transaction failures and processing errors and work with stakeholders to resolve issues.
Support regression cycles and release activities related to EDI deliverables.
Collaborate with QA, business, and integration teams to ensure requirements are met.
Participate in Agile ceremonies and provide estimates and status updates.
Prepare and maintain technical documentation and mapping specifications.
Provide operational and post deployment support for production EDI systems.
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