Senior Edifecs Analyst – Healthcare EDI & Core Admin Platform
Location: Onshore USA - Remote
Experience: 8–12 years
Tech Stack: Edifecs (SpecBuilder, XEngine, Transaction/EDI Gateway, Encounter Management), J2EE, MongoDB, PostgreSQL, Oracle, X12 EDI (270/271, 834, 835/837, 275, 276/277), AI-Assisted Development
Role Overview
We are looking for a Senior Edifecs Analyst to build, configure, and support the EDI integration layer of our large healthcare core administration platform. This is an execution-focused, hands-on role: you will implement trading partner configurations, transaction maps, and validation rules under the direction of the onsite Lead Edifecs Analyst, and provide day-to-day production support for high-volume EDI transaction processing.
Key Responsibilities
• Build, configure, and maintain Edifecs trading partner configurations, transaction maps, and validation rules for X12 transactions (270/271, 834, 835/837, 275, 276/277)
• Develop and customize J2EE-based components to extend Edifecs functionality and support integration with the core administration platform
• Implement and maintain data models and queries across MongoDB, PostgreSQL, and Oracle databases supporting EDI processing
• Execute unit, integration, and end-to-end testing of Edifecs configurations and EDI transaction flows
• Provide day-to-day production support for EDI transaction processing, including troubleshooting, debugging, and resolving transaction failures and rejections
• Support onboarding of new trading partners, including testing and certification of EDI transaction exchanges
• Document Edifecs configurations, mapping specifications, and support runbooks
• Collaborate with the onsite lead and client stakeholders on requirements clarification and design validation
• Participate in code/configuration reviews and follow established Edifecs and EDI development standards
• Support broader platform modernization initiatives by providing EDI/Edifecs subject matter expertise as needed
Required Qualifications
• Bachelor's degree in Computer Science, Engineering, or a related field
• 8–12 years of experience in healthcare EDI/integration engineering, with strong, hands-on experience in the Edifecs product suite (e.g., SpecBuilder, XEngine, Transaction/EDI Gateway)
• Strong, hands-on experience with J2EE for customizing and extending Edifecs and related integration components
• Strong, hands-on experience with MongoDB, PostgreSQL, and Oracle databases supporting EDI/integration platforms
• Strong working knowledge of core HIPAA X12 EDI transactions: 270/271, 834, 835/837, 275, and 276/277
• Experience building, testing, and supporting production EDI transaction flows in a health plan/payer environment
• Strong debugging and production-support skills for high-volume EDI transaction processing
• Good written and verbal communication skills for collaborating with onsite leads and client stakeholders
AI Knowledge & AI-Assisted Development (Required)
• Daily, practical use of AI coding/assistant tools to accelerate Edifecs map/transformation development, J2EE code, and test-case creation
• Able to critically review and validate AI-generated code, maps, and configurations for correctness before deployment
• Understanding of secure and compliant AI tool usage, including never entering PHI, member data, or other sensitive information into prompts or external AI tools
• Able to identify where AI-driven automation can improve day-to-day EDI development, testing, or support efficiency
Preferred Qualifications
• Experience with health plan/payer core administration systems (e.g., Facets, QNXT, HealthRules)
• Exposure to CAQH CORE operating rules
• Experience with mainframe or cloud-based integration patterns supporting EDI processing
• Relevant certifications: Edifecs product certifications