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
Nice to Have
HL7/FHIR MuleSoft, Boomi Groovy, JavaScript, PowerShell, Shell Scripting Blues experience
Numbers & Facts
Location
Seattle, WA
Skills
Alliance/Partner Managementunmatched
Application Programming Interface (API)unmatched
Claims Processingunmatched
Ecosystemsunmatched
Electronic Data Interchange (EDI)unmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Healthcareunmatched
JSONunmatched
Linux Operating Systemunmatched
Microsoft BizTalk Serverunmatched
Microsoft SQL Serverunmatched
Onboardingunmatched
Oracle Databaseunmatched
Oracle Solaris (fka Sun Microsystems Solaris)unmatched
Secure/SSH File Transfer Protocol (SFTP)unmatched
Transaction Processing/Managementunmatched
XML (EXtensible Markup Language)unmatched
XSD (XML Schema Definition)unmatched
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