Healthcare EDI Developer

DATAMAXIS

Healthcare EDI Developer

Okemos, MI
Full Time
Paid
  • Responsibilities

    Summary: We are expanding our Encounter Development team and seeking a Healthcare EDI Developer to support enterprise encounter reporting through timely, accurate generation and submission of 837D X12 encounter files.

    Job Responsibilities

    • Execute recurring operational tasks to generate encounter data files; monitor daily production jobs, troubleshoot issues, and drive error investigation through resolution.

    • Design, build, and maintain X12 EDI 837 encounter processing workflows.

    • Ensure solutions comply with HIPAA and X12 standards, including state- and client-specific implementation guides.

    • Perform unit, integration, and regression testing for EDI processes and related data flows.

    • Interpret and reconcile 999, 277, 835, and custom state/client response files associated with encounter submissions.

    • Develop and maintain data mappings between internal application data models and EDI segments/loops.

    • Implement corrective actions to remediate defects and reduce or eliminate repeat issues.

    • Partner with external clients and internal operational teams on new client implementations and changes to existing submissions.

    • Create and execute EDI test plans and provide clear, timely status updates to internal stakeholders and clients.

    Experience and Qualifications

    • 3+ years of relevant experience in the healthcare industry, Dental preferred

    • 3+ years of experience in a data analyst role, preferably supporting healthcare EDI.

    • 1+ years of experience developing post-adjudication X12 837 files (required).

    • 1+ years of SQL experience.

    • Working knowledge of HIPAA X12 standards, specifically the 837 claim/encounter transaction.

    • Strong attention to detail with the ability to analyze client needs and accurately document processes.

    • Excellent analytical, troubleshooting, and communication skills.

    • Experience with IBM Sterling B2B Integrator is preferred.