Healthcare EDI (837/Encounter) Developer

RESPONSIBILITIES:
Kforce's client, a growing organization in Okemos, MI, is expanding its encounter data development capabilities to support enterprise reporting and regulatory submissions. The team focuses on building and maintaining reliable electronic data interchange (EDI) workflows that ensure accurate and timely transmission of healthcare encounter data while maintaining compliance with industry standards.

Key Responsibilities:
* Execute recurring operational processes to generate healthcare encounter data files, including monitoring daily production jobs and resolving processing issues
* Design, develop, and maintain electronic data interchange workflows supporting X12 837 encounter file generation and submission
* Ensure solutions comply with applicable healthcare data standards, including HIPAA and X12 implementation requirements
* Conduct unit, integration, and regression testing to validate EDI processes and related data flows
* Analyze and reconcile response transactions such as 999, 277, 835, and other payer or regulatory acknowledgments
* Develop and maintain mappings between internal application data models and EDI transaction segments and loops
* Identify defects and implement corrective actions to improve data accuracy and reduce recurring issues
* Collaborate with internal operational teams and external partners to support new client implementations and updates to existing data submissions
* Create and execute structured EDI testing plans and provide status updates to stakeholders throughout implementation and maintenance activities

REQUIREMENTS:
* 3+ years of experience in the healthcare industry; experience supporting dental data workflows is considered an asset
* 3+ years of experience in a data analysis or data-focused technical role supporting healthcare EDI processes
* 1+ years of experience developing post-adjudication X12 837 encounter or claim files
* 1+ years of experience writing and working with SQL
* Working knowledge of healthcare EDI standards, particularly HIPAA X12 837 transactions
* Strong analytical and troubleshooting skills with a high level of attention to detail
* Ability to interpret client requirements and accurately document technical processes
* Effective written and verbal communication skills
* Experience with enterprise EDI platforms such as IBM Sterling B2B Integrator is considered an asset

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

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