Role: Healthcare EDI Developer
Summary
We are expanding our Encounter Development team and seeking a Healthcare EDI Developer to support enterprise encounter reporting through timely, accurate generation and submission of 837D X12 encounter files.
Job Responsibilities
· Execute recurring operational tasks to generate encounter data files; monitor daily production jobs, troubleshoot issues, and drive error investigation through resolution.
· Design, build, and maintain X12 EDI 837 encounter processing workflows.
· Ensure solutions comply with HIPAA and X12 standards, including state- and client-specific implementation guides.
· Perform unit, integration, and regression testing for EDI processes and related data flows.
· Interpret and reconcile 999, 277, 835, and custom state/client response files associated with encounter submissions.
· Develop and maintain data mappings between internal application data models and EDI segments/loops.
· Implement corrective actions to remediate defects and reduce or eliminate repeat issues.
· Partner with external clients and internal operational teams on new client implementations and changes to existing submissions.
· Create and execute EDI test plans and provide clear, timely status updates to internal stakeholders and clients.
Experience and Qualifications
· 3+ years of relevant experience in the healthcare industry, Dental preferred
· 3+ years of experience in a data analyst role, preferably supporting healthcare EDI.
· 1+ years of experience developing post-adjudication X12 837 files (required).
· 1+ years of SQL experience.
· Working knowledge of HIPAA X12 standards, specifically the 837 claim/encounter transaction.
· Strong attention to detail with the ability to analyze client needs and accurately document processes.
· Excellent analytical, troubleshooting, and communication skills.
· Experience with IBM Sterling B2B Integrator is preferred.
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