Job Description
Senior EDI Developer (Healthcare Payer | Facets Ecosystem) Experience: 8+ Years IT | 5+ Years Healthcare Payer & EDI | 3+ Years Edifecs/TriZetto HIPAA Gateway Summary: Seeking a Senior EDI Developer with strong Healthcare Payer experience to design, develop, and optimize HIPAA X12 integrations within a Facets-based ecosystem. The role requires hands-on expertise in Edifecs/TriZetto HIPAA Gateway, EDI mapping, trading partner integrations, and high-volume transaction processing across Claims, Membership, Enrolment, Provider and Payment domains.
Responsibilities
- Design, develop, and optimize EDI solutions using Edifecs, TriZetto HIPAA Gateway, BizTalk, or equivalent platforms.
- Develop EDI mappings, validations, routing logic, and trading partner integrations.
- Implement and support HIPAA X12 transactions across Claims, Membership, Enrolment, Provider, and Payment domains.
- Perform EDI map optimization and support high-volume transaction processing.
- Support trading partner onboarding, testing, certification, and production deployments.
- Collaborate with Facets and business teams to deliver EDI enhancements and integrations.
Required Skills
- Edifecs Suite (XEngine, SpecBuilder, Trading Partner Management, Validation & Compliance)
- TriZetto HIPAA Gateway, BizTalk Server
- Facets
- SQL Server/Oracle
- Unix/Linux
- SFTP, Batch Processing, API Integrations
- XML/XSD, JSON
Required Experience
- Hands-on development and optimization of: 834, 837 (Professional/Institutional/Dental), 835 270/271, 276/277, 278, 820 TA1, 999, and 277CA acknowledgements
Expectations from this role
Independently develops error free code with high quality validation of applications, guides other developers and assists Lead 1 - Software Engineering
Typical performance measures
- Adherence to engineering process and standards (coding standards)
- Adherence to schedule / timelines
- Adhere to SLAs where applicable
- Number of defects post delivery
- Number of non-compliance issues
- Reduction of reoccurrence of known defects
- Quick turnaround of production bugs
- Meet the defined productivity standards for project
- Number of reusable components created
- Completion of applicable technical/domain certifications
- Completion of all mandatory training requirements
Performance Areas
Code: Develop code independently for the above
Configure: Implement and monitor configuration process
Test: Create and review unit test cases, scenarios and execution
Domain relevance: Develop features and components with good understanding of the business problem being addressed for the client
Manage Project: Manage module level activities
Manage Defects: Perform defect RCA and mitigation
Estimate: Estimate time, effort, resource dependence for one's own work and others' work, including modules
Document: Create documentation for own work as well as perform peer review of documentation of others' work
Manage knowledge: Consume and contribute to project related documents, share point, libraries and client universities
Status Reporting: Report status of tasks assigned
Comply with project related reporting standards/process
Release: Execute release process
Design: LLD for multiple components
Skill Examples
- Explain and communicate the design / development to the customer
- Perform and evaluate test results against product specifications
- Develop user interfaces, business software components and embedded software components
- Manage and guarantee high levels of cohesion and quality
- Use data models
- Estimate effort, and resources required for developing / debugging features / components
- Perform and evaluate test in the customer or target environment
- Team Player
- Good written and verbal communication abilities
- Proactively ask for help and offer help
Knowledge Examples
- Appropriate software programs / modules
- Technical designing
- Programming languages
- DBMS
- Operating Systems and software platforms
- Integrated development environment (IDE)
- Agile methods
- Knowledge of customer domain and sub domain where problem is solved
Education/Experience Requirements
Graduate in Engineering or MCA/Equivalent with 3 years of Software Engineering experience
Graduate in Science/Commerce or BCA/Equivalent with 4 years of Software Engineering experience