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Edifecs Developer

Job not on LinkedIn

🔥 7 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

đźź  Senior

đź–Ą Software Engineer

🦅 H1B Visa Sponsor

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đź‘» Ghost score 10%

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Tegria

1001 - 5000 employees

Founded 2020

đź’Ľ Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

Tegria is a global healthcare consulting and services company that partners with provider and payer organizations to advance care, improve performance, and tackle the biggest challenges in healthcare. They offer a range of services including patient access optimization, data analytics, cloud solutions, and revenue cycle transformation to create value and enhance healthcare delivery. Tegria focuses on streamlining operations, fostering innovation, and leveraging technology to maximize performance and improve patient experiences.

đź“‹ Description

• Design, develop, configure, and maintain Edifecs applications and healthcare EDI interfaces • Develop and support HIPAA transaction processing, including 834, 835, 837, 270/271, 276/277, and 278 transactions • Configure and maintain Edifecs modules including XEngine, SpecBuilder, Transaction Management, and STPM • Analyze business requirements and translate them into technical solutions • Create mapping specifications and validation rules for inbound and outbound healthcare transactions • Troubleshoot production issues, perform root cause analysis, and resolve data integration problems • Collaborate with business analysts, product owners, vendors, and operations teams to improve EDI workflows • Support unit, integration, regression, and user acceptance testing • Ensure compliance with HIPAA regulations and healthcare industry standards • Develop technical documentation, design documents, and support procedures

🎯 Requirements

• Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or related field • 3+ years of Edifecs development experience in a healthcare payer environment • Strong experience with Edifecs XEngine, SpecBuilder, Translator, and STPM • Knowledge of HIPAA EDI transactions (834, 835, 837, 270/271, 276/277, 278) • Experience with XML, X12 EDI, SQL, Java, and Web Services • Familiarity with healthcare claims, enrollment, provider, and eligibility processes • Experience troubleshooting production support issues and implementing fixes • Strong analytical, problem-solving, and communication skills • Experience working with Medicare, Medicaid, and Commercial Health Plans preferred • Knowledge of FHIR APIs and modern healthcare interoperability standards preferred • Experience with cloud platforms such as Azure or AWS preferred • Healthcare payer or managed care industry experience preferred • Edifecs certification preferred

🏖️ Benefits

• Multiple health and dental plans with nationally recognized networks • Vision benefits • Total wellness program • Employee assistance program for you and your family • Competitive wages • Retirement savings plans • Company-paid disability and life insurance • Pre-tax savings opportunities (HSA and/or FSA) • Professional development offerings • Opportunities for remote work • Generous paid-time-off program • Flexible scheduling to accommodate vacations, illness, life events, and unexpected circumstances

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