Senior EDI Support Specialist
Healthcare Payer | Facets Ecosystem
Experience: 8+ Years IT | 5+ Years Healthcare Payer & EDI | 3+ Years Edifecs/TriZetto HIPAA Gateway
Duration: Towards the end of year with possible extension.
REMOTE ROLE
NOTE: Must have facets with claims experience and also on Claims, Membership, Enrolment, Billing, Provider, and Payment.
Summary
Seeking a Senior EDI Support Specialist with strong Healthcare Payer experience to provide L2/L3 support for enterprise EDI platforms supporting Claims, Membership, Enrolment, Provider, and Payment functions. The role requires expertise in HIPAA X12 transaction support, production monitoring, incident resolution, trading partner management, and Edifecs/TriZetto HIPAA Gateway environments.
Responsibilities
- Provide L2/L3 support for EDI platforms supporting Claims, Membership, Enrolment, Billing, Provider, and Payment functions.
- Monitor, troubleshoot, and resolve EDI transaction failures, rejects, reconciliation, and file transmission issues.
- Support Edifecs, TriZetto HIPAA Gateway, BizTalk, and Facets-integrated environments.
- Perform RCA, incident resolution, and transaction performance improvements.
- Support trading partner onboarding, certification, testing, and production releases.
- Work with business users, vendors, and external trading partners to resolve operational issues.
Required Skills
- Edifecs Suite
- TriZetto HIPAA Gateway
- BizTalk Server
- Facets
- SQL Server/Oracle
- Unix/Linux
- SFTP
- Batch Processing
- API Integrations
- XML/XSD
- JSON
Required Experience
Hands-on support, troubleshooting, and optimization of:
- 834
- 837 (Professional/Institutional/Dental)
- 835
- 270/271
- 276/277
- 278
- 820
- TA1
- 999
- 277CA acknowledgements
Nice to Have
- HL7/FHIR
- ServiceNow
- MuleSoft, Boomi
- Groovy, JavaScript, PowerShell, Shell Scripting
Preferred
Strong healthcare payer domain knowledge with proven experience supporting large-scale EDI operations, trading partner management, and Facets-integrated ecosystems.
Additional Job Description
- Ensure on time delivery and support to meet client requirements on product/project specifications. Manage team activities and ensure readiness of the support echo system for customers.
- Understand and analyse business and technical specifications and requirements as well as the impact to product/application/system.
- Create innovative solutions to meet the support needs of our customers.
- Plan and implement User Success team's defined and evolving processes.
- Drive all technical and functional issues towards closure.
- Co-ordinate with product engineers for application bug and enhancement requirements.
- Responsible for building and maintaining up-to-date product documentation/knowledge base.
- Respond to user inquires through various communication channels including phone, email, chat, etc. Answer questions regarding how to use the product and tool features to accomplish their specific tasks or milestones.
- Lead the associates and own the quality and timeliness of their work.