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EDI X12 Developer

PLANSTREET INC

EDI X12 Developer

Lexington, KY
Full Time
Paid
  • Responsibilities

    Benefits:

    Health insurance

    Dental insurance

    Vision insurance

    About the Role:

    With the growing demand for PlanStreet’s StreetRCM platform, we are expanding our team. We are seeking a skilled Backend Developer with expertise in healthcare EDI transactions, particularly X12 837 (Claims) and X12 835 (Remittance Advice), to help drive the development and optimization of our revenue cycle management solutions.

    The ideal candidate will design, develop, and maintain backend systems for processing high-volume healthcare claims and remittances using C#, .NET, and SQL Server, ensuring compliance with HIPAA and industry standards.

    Key Responsibilities

    EDI & Healthcare Transactions

    Design, implement, and maintain the processing of X12 EDI 837 Professional, Institutional, and Dental claims

    Implement parsing, validation, transformation, and posting of EDI 835 remittance advice

    Handle claim lifecycle workflows, including submission, acknowledgments (999/277CA), adjudication, and payment posting

    Ensure compliance with HIPAA, X12 standards, and payer-specific implementation guides

    Support error handling, rejection management, and reconciliation of claims and remittances

    Backend Development

    Develop and maintain backend services using C#, .NET / .NET Core

    Design efficient and scalable SQL Server schemas, stored procedures, and queries

    Optimize batch processing for high-volume EDI files

    Build APIs and background services for EDI ingestion and outbound processing

    Implement logging, monitoring, and audit trails for EDI transactions

    Integration & Data Processing

    Integrate with clearinghouses, payers, and external healthcare systems

    Process inbound/outbound files via SFTP, APIs, or EDI gateways

    Implement data mapping between EDI segments and internal application data models

    Support file batching, splitting, merging, and scheduling

    Quality, Security & Compliance

    Perform unit, integration, and regression testing of EDI workflows

    Ensure PHI security, encryption, and access control

    Support compliance audits and production issue resolution

    Maintain technical documentation for EDI processes and system architecture

    Required Qualifications

    5+ years of backend development experience using C# and SQL Server

    Strong hands-on experience with X12 EDI standards, specifically:

    837 (Professional, Institutional, Dental)

    835 (Remittance Advice)

    Solid understanding of healthcare revenue cycle management (RCM)

    Experience with HIPAA compliance and healthcare data security

    Proficiency in SQL Server performance tuning, indexing, and stored procedures

    Experience processing batch files and large datasets

    Familiarity with SFTP, EDI translators, and clearinghouse integrations

    Preferred / Nice-to-Have Skills

    Experience with 999, 277CA, 270/271, 276/277 transactions

    Knowledge of payer-specific EDI rules

    Experience with Azure Integration account and Logic App X12 Connector

    Familiarity with microservices architecture

    Experience with EDI validation tools or translators

    Healthcare domain certifications or prior payer/clearinghouse experience

    Soft Skills

    Strong analytical and problem-solving skills

    Ability to work independently on complex EDI workflows

    Good communication skills for cross-functional collaboration

    Attention to detail, especially with healthcare compliance

    Featured benefits

    Medical insurance, Vision insurance, Dental insurance Apply by sending your resume: careers@planstreetinc.com