EDI Support Specialist
Contract W2
2 Months
No Travel Required
On-site
$50/hr
Abacus Service Corporation
Fitment
Dice Job Match Score™
🔢 Crunching numbers...
Job Details
Skills
- Facts
- Claims
Summary
Note: NO C2C or 1099
We are seeking an experienced Senior EDI Support Specialist with strong Healthcare Payer domain knowledge and hands-on experience supporting Facets-integrated claims processing environments. The ideal candidate will have expertise in L2/L3 EDI production support, HIPAA X12 transactions, Edifecs Suite, TriZetto HIPAA Gateway, and trading partner management.
The candidate will be responsible for monitoring, troubleshooting, and resolving EDI transaction issues across claims, enrollment, membership, provider, billing, and payment functions. Strong Facets claims experience, including 837 claims processing and 835 payment transactions, is mandatory.
Key Responsibilities
- Provide L2/L3 production support for healthcare payer EDI platforms integrated with Facets.
- Monitor, troubleshoot, and resolve EDI transaction failures, rejected files, data mapping issues, and reconciliation discrepancies.
- Support HIPAA X12 transactions, including enrollment, claims, eligibility, claim status, prior authorization, and premium payment.
- Troubleshoot 837 Professional, Institutional, and Dental claims and 835 claims payment/remittance transactions.
- Support Edifecs Suite, TriZetto HIPAA Gateway, BizTalk Server, and related integration environments.
- Perform root cause analysis (RCA), incident resolution, and preventive maintenance.
- Manage trading partner onboarding, connectivity, certification, testing, and production releases.
- Monitor SFTP file transfers, batch processing, and production EDI workflows.
- Write and execute SQL queries to investigate claims, enrollment, and transaction processing issues.
- Collaborate with business users, claims operations teams, vendors, and external trading partners to resolve production issues.
- Maintain operational documentation and ensure compliance with HIPAA EDI standards and service-level agreements.
Required Technical Skills
- Healthcare Payer Domain – 5+ years
- EDI L2/L3 Support – 5+ years
- HIPAA X12 Transactions – 5+ years
- Facets – 3+ years with hands-on claims experience
- Edifecs Suite – 3+ years
- TriZetto HIPAA Gateway – 3+ years
- Trading Partner Management – 3+ years
- BizTalk Server and API integrations
- SQL Server or Oracle
- Unix/Linux
- SFTP and batch processing
- XML/XSD and JSON
Mandatory HIPAA X12 Transaction Experience
Candidates must have hands-on experience supporting the following transactions:
- 834: Enrollment and maintenance
- 837P / 837I / 837D: Professional, Institutional, and Dental claims
- 835: Claims payment and remittance advice
- 270/271: Eligibility inquiry and response
- 276/277: Claim status inquiry and response
- 278: Healthcare services review and prior authorization
- 820: Premium payment
- TA1 / 999 / 277CA: EDI acknowledgements, claim acceptance, and rejection handling
Preferred Qualifications
- Experience supporting large-scale healthcare payer implementations and Facets environments.
- Knowledge of HL7/FHIR standards.
- Experience with ServiceNow, MuleSoft, or Boomi.
- Familiarity with Groovy, JavaScript, PowerShell, or Shell scripting.
- Strong analytical, troubleshooting, communication, and stakeholder management skills.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
- Dice Id: 10122208
- Position Id: 9116949
- Posted 3 hours ago
Company Info
Abacus Service Corporation is a full service employment solutions firm designed around the ability to provide agile contingent workforce solutions.
Formed in 2004 by industry veterans, Abacus Service Corporation implemented guiding principles with best in industry processes and innovative technologies, to form an influential force in employment solutions. Abacus Service Corporation was founded in Farmington Hills, Michigan and has grown to become a nationwide presence with offices in 18 locations and two international offices. Through our locations, Abacus has been able to offer our clients cost effective and quality employment solutions regardless of the geographic coverage based on our successful strategies. Abacus is a privately held company with employees in 27 US states and four Canadian Provinces. Abacus is MBE and WBE certified nationally and upholds our commitment to diversity by adhering to a philosophy of recruiting employees from diverse backgrounds. Our extensive experience, passion to deliver the best in class solutions, and dedication to customer service has allowed Abacus to become the workforce ally of our clientele.
Formed in 2004 by industry veterans, Abacus Service Corporation implemented guiding principles with best in industry processes and innovative technologies, to form an influential force in employment solutions. Abacus Service Corporation was founded in Farmington Hills, Michigan and has grown to become a nationwide presence with offices in 18 locations and two international offices. Through our locations, Abacus has been able to offer our clients cost effective and quality employment solutions regardless of the geographic coverage based on our successful strategies. Abacus is a privately held company with employees in 27 US states and four Canadian Provinces. Abacus is MBE and WBE certified nationally and upholds our commitment to diversity by adhering to a philosophy of recruiting employees from diverse backgrounds. Our extensive experience, passion to deliver the best in class solutions, and dedication to customer service has allowed Abacus to become the workforce ally of our clientele.
Create job alert
Never miss an opportunity! Create an alert based on the job you applied for.