Electronic Data Interchange Specialist
: Job Details :

Role : EDI Integration Specialist (Not Developer)

Location : Remote

Experience : 12+ years

Contract

• External facing experience is MUST
• We are seeking a skilled Integration Specialist with strong Electronic Data Interchange (EDI) expertise and a solid understanding of healthcare domain standards to design, develop, and maintain integration solutions.
• This role will focus on implementing, testing, and supporting EDI transactions, ensuring compliance with HIPAA and healthcare industry standards.

Key Responsibilities

∙Design, develop, and maintain integration solutions for healthcare data exchange using EDI standards (e.g., X12, HL7).

∙Implement, configure, and support EDI transactions such as 837 (claims), 835 (remittance), 270/271 (eligibility), 276/277 (claim status).

∙Work with healthcare partners, payers, and providers to troubleshoot and resolve integration issues.

∙Develop mapping, translation, and transformation processes between internal systems and external partners.

∙Ensure compliance with HIPAA, security protocols, and industry data exchange requirements.

∙Collaborate with business analysts, QA teams, and project managers to gather requirements and deliver high-quality integration solutions.

∙Monitor integration processes and proactively identify performance or data issues.

∙Maintain detailed technical documentation and provide training or knowledge transfer to internal teams.

Required Skills & Qualifications

∙Bachelor's degree in Computer Science, Information Technology, or related field (or equivalent experience).

∙5+ years of experience in integration development, with a strong focus on EDI in the healthcare industry.

∙Proficiency in healthcare EDI standards (HIPAA X12, HL7).

∙Hands-on experience with integration tools (e.g., MuleSoft, Dell Boomi, Cloverleaf, IBM Sterling Integrator, BizTalk, or similar).

∙Strong knowledge of healthcare processes including claims, eligibility, payments, and prior authorizations.

∙Solid understanding of XML, JSON, SQL, REST, and SOAP-based web services.

∙Strong troubleshooting and problem-solving skills.

∙Excellent communication and collaboration abilities.

Preferred Qualifications

∙Experience with cloud-based integration platforms (e.g., Azure Logic Apps, AWS Step

Functions, or GCP integrations).

∙Knowledge of FHIR (Fast Healthcare Interoperability Resources) standards.

∙Previous work with payer or provider systems.

∙Familiarity with agile development methodologies.