Pega SSA Developer - Healthcare Claims Facets / EDI 837/835

Iconma LLC
  • VA
    3 days ago

    Job Description

    Our client, an IT Services and Consulting company, is looking for a Pega SSA Developer - Healthcare Claims Facets / EDI 837/835 for their Remote location.

    Responsibilities:

    • Pega Developer with experience in Designing, developing and configuring Pega applications for Healthcare Claims processing. Skilled in building flows in Pega, integrating with application called Facets and analyzing and translating the business requirements.
    • Experienced in collaborating with business analysts, architects, and QA teams to deliver high quality applications.
    • Design, develop, and configure Pega applications for healthcare claims processing, adjudication, and workflow automation integrated with Facets.
    • Work on Facets modules (Claims, Membership, Billing, Provider) to support end-to-end claims lifecycle management including intake, adjudication, and payment processing.
    • Build and customize Pega case types, flows, decision rules, and UI rules to automate claims exception handling and manual review processes.
    • Integrate Pega with Facets and other core administration systems using REST/SOAP APIs, connectors, and data pages.
    • Analyze and translate healthcare claims business requirements (HIPAA, EDI 837/835, X12 transactions) into Pega application design.

    Requirements:

    • Required Skills:
    • Pega
    • Facets (Claims, Membership,Billing,Provider)
    • EDI 835, 837
    • Good collaboration with business and other teams
    • Years of Experience: 10+ Years of Experience

    Why Should You Apply?

    • Health Benefits
    • Referral Program
    • Excellent growth and advancement opportunities

    Numbers & Facts

    LocationVA

    Skills

    • Adjudicationunmatched
    • Analysis Skillsunmatched
    • Application Programming Interface (API)unmatched
    • Automationunmatched
    • Billingunmatched
    • Claims Managementunmatched
    • Claims Processingunmatched
    • Electronic Data Interchange (EDI)unmatched
    • Error Handlingunmatched
    • HIPAA (Health Insurance Portability and Accountability Act)unmatched
    • Health Planunmatched
    • Healthcareunmatched
    • Healthcare Softwareunmatched
    • Information Technology Consultingunmatched
    • Payment Processingunmatched
    • REST (Representational State Transfer)unmatched
    • SOAP (Simple Object Access Protocol)unmatched
    • Software Designunmatched
    • User Interface/Experience (UI/UX)unmatched

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