EDI Specialist

EDI Specialist

Posted 4 days ago by 1756437642

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Negotiable
Outside
Remote
USA
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Agile Methodology Amazon Web Services (AWS) Azure Logic Apps Cloud-Based Integration Cloud Computing Cloud Technology Computer Science Data Exchange Dell Boomi (Integration Platform) Electronic Data Interchange Extensible Markup Language (XML) Google Cloud Google Cloud Platform (GCP) IBM Software Information Technology Integration Platforms Interoperability JSON Mapping Software Microsoft Azure Microsoft Biztalk Servers MuleSoft Remittance Software Development SQL (Programming Language) Stakeholder Management Technical Documentation Web Services

Summary: The EDI Specialist role is focused on designing, developing, and maintaining integration solutions for healthcare data exchange using Electronic Data Interchange (EDI) standards. The position requires extensive experience in EDI within the healthcare domain, ensuring compliance with HIPAA and industry standards. The specialist will collaborate with various stakeholders to troubleshoot integration issues and deliver high-quality solutions. This is a long-term remote contract position.

Key Responsibilities:

  • Design, develop, and maintain integration solutions for healthcare data exchange using EDI standards (e.g., X12, HL7).
  • Implement, configure, and support EDI transactions such as 837 (claims), 835 (remittance), 270/271 (eligibility), 276/277 (claim status).
  • Work with healthcare partners, payers, and providers to troubleshoot and resolve integration issues.
  • Develop mapping, translation, and transformation processes between internal systems and external partners.
  • Ensure compliance with HIPAA, security protocols, and industry data exchange requirements.
  • Collaborate with business analysts, QA teams, and project managers to gather requirements and deliver high-quality integration solutions.
  • Monitor integration processes and proactively identify performance or data issues.
  • Maintain detailed technical documentation and provide training or knowledge transfer to internal teams.

Key Skills:

  • Bachelor's degree in Computer Science, Information Technology, or related field (or equivalent experience).
  • 5+ years of experience in integration development, with a strong focus on EDI in the healthcare industry.
  • Proficiency in healthcare EDI standards (HIPAA X12, HL7).
  • Hands-on experience with integration tools (e.g., MuleSoft, Dell Boomi, Cloverleaf, IBM Sterling Integrator, BizTalk, or similar).
  • Strong knowledge of healthcare processes including claims, eligibility, payments, and prior authorizations.
  • Solid understanding of XML, JSON, SQL, REST, and SOAP-based web services.
  • Strong troubleshooting and problem-solving skills.
  • Excellent communication and collaboration abilities.

Salary (Rate): undetermined

City: undetermined

Country: USA

Working Arrangements: remote

IR35 Status: outside IR35

Seniority Level: undetermined

Industry: IT

Detailed Description From Employer:

Role: EDI Specialist
Location: Remote
Duration: Long Term Contract Job Description:

  • Experience level: 12-15+ Years
  • We are seeking a skilled Integration Developer with strong Electronic Data Interchange (EDI) expertise and a solid understanding of healthcare domain standards to design, develop,
  • and maintain integration solutions.
  • This role will focus on implementing, testing, and supporting EDI transactions, ensuring compliance with HIPAA and healthcare industry standards.


Key Responsibilities

  • Design, develop, and maintain integration solutions for healthcare data exchange using EDI standards (e.g., X12, HL7).
  • Implement, configure, and support EDI transactions such as 837 (claims), 835 (remittance), 270/271 (eligibility), 276/277 (claim status).
  • Work with healthcare partners, payers, and providers to troubleshoot and resolve integration issues.
  • Develop mapping, translation, and transformation processes between internal systems and external partners.
  • Ensure compliance with HIPAA, security protocols, and industry data exchange requirements.
  • Collaborate with business analysts, QA teams, and project managers to gather requirements and deliver high-quality integration solutions.
  • Monitor integration processes and proactively identify performance or data issues.
  • Maintain detailed technical documentation and provide training or knowledge transfer to internal teams.


Required Skills & Qualifications

  • Bachelor s degree in Computer Science, Information Technology, or related field (or equivalent experience).
  • 5+ years of experience in integration development, with a strong focus on EDI in the healthcare industry.
  • Proficiency in healthcare EDI standards (HIPAA X12, HL7).
  • Hands-on experience with integration tools (e.g., MuleSoft, Dell Boomi, Cloverleaf, IBM Sterling Integrator, BizTalk, or similar).
  • Strong knowledge of healthcare processes including claims, eligibility, payments, and prior authorizations.
  • Solid understanding of XML, JSON, SQL, REST, and SOAP-based web services.
  • Strong troubleshooting and problem-solving skills.
  • Excellent communication and collaboration abilities.

Preferred Qualifications

  • Experience with cloud-based integration platforms (e.g., Azure Logic Apps, AWS Step Functions, or Google Cloud Platform integrations).
  • Knowledge of FHIR (Fast Healthcare Interoperability Resources) standards.
  • Previous work with payer or provider systems.
  • Familiarity with agile development methodologies.
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