Job Description
Our Client, an IT Services and Consultant company, is looking for a Pega & Informatica Healthcare Developer - EDI / Claims for their Remote location.
Responsibilities:
- 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.
Requirements:
- PEGA PRPC
- Informatica
- Healthcare EDI transactions
- Years of experience: 8+ Years of Experience
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
Skills
Agile Programming Methodologiesunmatched
Application Programming Interface (API)unmatched
Business Analysisunmatched
Claims Processingunmatched
Code Reviewsunmatched
Data Qualityunmatched
Database Extract Transform and Load (ETL)unmatched
Electronic Data Interchange (EDI)unmatched
Error Handlingunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Health Planunmatched
Healthcareunmatched
Healthcare Softwareunmatched
Identify Issuesunmatched
Informaticaunmatched
Information Technology Consultingunmatched
Messaging Middlewareunmatched
Performance Tuning/Optimizationunmatched
Production Supportunmatched
REST (Representational State Transfer)unmatched
Reconciliationunmatched
SOAP (Simple Object Access Protocol)unmatched
SOAP Notesunmatched
Service Level Agreement (SLA)unmatched
Software Designunmatched
Software Developmentunmatched
Sprint Planningunmatched
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