Job Summary
We are seeking an experienced Senior EDI Support Specialist with strong healthcare payer domain knowledge and hands-on experience supporting enterprise EDI platforms integrated with TriZetto Facets. The ideal candidate will have expertise in HIPAA X12 transactions, Edifecs, TriZetto HIPAA Gateway, BizTalk Server, and production support operations.
The candidate will be responsible for monitoring EDI transaction processing, troubleshooting production issues, managing trading partner integrations, resolving transaction failures, and ensuring reliable data exchange across claims, membership, enrollment, provider, billing, and payment systems.
Required Technical Skills
- EDI Platforms: Edifecs Suite, TriZetto HIPAA Gateway, BizTalk Server.
- Healthcare Payer Systems: TriZetto Facets integration and payer operations.
- HIPAA X12 Transactions: 834, 837 Professional/Institutional/Dental, 835, 270/271, 276/277, 278, 820.
- EDI Acknowledgments: TA1, 999, 277CA.
- Database Technologies: SQL Server and/or Oracle; SQL queries, joins, data validation, and troubleshooting.
- Operating Systems: Unix/Linux, log analysis, shell commands, and batch job troubleshooting.
- File Transfer & Integration: SFTP, batch processing, file transmission monitoring, and API integrations.
- Data Formats: XML, XSD, and JSON.
- Production Support: L2/L3 incident management, root cause analysis, troubleshooting, monitoring, and problem resolution.
Required Experience and Qualifications
- 8+ years of overall IT experience.
- 5+ years of experience in healthcare payer systems and EDI operations.
- 3+ years of hands-on experience with Edifecs and/or TriZetto HIPAA Gateway environments.
- Strong practical knowledge of HIPAA X12 transaction processing and healthcare EDI workflows.
- Experience supporting Facets-integrated healthcare payer platforms.
- Proven experience in production support, incident resolution, transaction reconciliation, and trading partner management.
- Strong analytical, troubleshooting, communication, and cross-functional collaboration skills.
