Job Description – Full Stack .NET Healthcare Claims Developer (Facets / Medicare-Medicaid)
Full Stack .NET Healthcare Claims Developer with strong expertise in healthcare payer systems, claims adjudication, and Facets Claims Engine to support a Community & State (Medicare/Medicaid) initiative. The ideal candidate will have hands-on experience in developing, enhancing, and integrating claims processing applications, with exposure to AI-assisted development tools like GitHub Copilot and OpenAI Codex to accelerate code quality, automation, and modernization.
Key Responsibilities:
• Design, develop, and support Full stack .NET-based healthcare claims applications using .Net technologies for Medicare/Medicaid and Community & State programs.
• Nice to have worked with Facets Claims Adjudication Engine, including claims workflows, pricing, edits, benefits, and payment logic.
• Build and maintain APIs, services, and integrations between Facets and upstream/downstream payer platforms.
• Analyze claims processing issues and enhance adjudication performance, accuracy, and compliance.
• Collaborate with business, product, and operations teams to implement claims enhancements and regulatory updates.
• Leverage Copilot / Codex / AI-assisted development tools for code optimization, documentation, unit testing, and modernization efforts.
• Support automation initiatives around claims processing, exception handling, and workflow efficiency.
Required Skills:
• 5+ years of experience in .NET Development (C#, ASP.NET, Web APIs, SQL Server)
• Strong healthcare payer experience with Claims Adjudication / Claims Processing
• Hands-on experience with Facets Claims Engine (pricing, benefits, edits, provider/member claims)
• Knowledge of Medicare / Medicaid / Community & State healthcare programs
• Experience with REST APIs, integrations, ETL, and backend system development
• Familiarity with AI development tools such as GitHub Copilot, OpenAI Codex, or similar AI coding assistants
• Strong SQL/query optimization and troubleshooting skills
• Understanding of HIPAA, compliance, and healthcare regulatory requirements
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