Required Skills
- PEGA PRPC
- Informatica
- Healthcare EDI transactions
Job Description
Design and develop healthcare applications using Pega Infinity/PRPC.
Configure and develop Case Types, Flows, Flow Actions, Data Pages, Data Transforms, Activities, Decision Rules, and SLAs.
Develop and support Informatica PowerCenter/IICS mappings, workflows, and ETL processes.
Integrate Pega applications with healthcare systems using REST/SOAP APIs, MQ, and Informatica services.
Work with healthcare claims data including Member, Provider, Benefits, Enrollment, Authorization, and Claims.
Analyze and implement business requirements related to Claims Processing, Prior Authorization, Appeals & Grievances, and Care Management.
Support healthcare EDI transactions including HIPAA X12 837, 835, 270/271, 276/277.
Develop data validation, exception handling, reconciliation, and audit frameworks.
Participate in Agile ceremonies, sprint planning, estimation, and code reviews.
Provide production support, troubleshooting, performance tuning, and defect resolution.
Years of Experience: 8+ Years of Experience