Senior EDI Developer / EDI developer
Job Description: Senior EDI Developer (Healthcare Payer | Facets Ecosystem) 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. Expectations from this role: Independently develops error free code with high quality validation of applications, guides other developers and assists Lead 1 - Software Engineering Understand and provide input to the application/feature/component designs; developing the same in accordance with user stories/requirements. Code, debug, test, document and communicate product/component/features at development stages. Select appropriate technical options for development such as reusing, improving or reconfiguration of existing components. Optimize efficiency, cost and quality by identifying opportunities for automation/process improvements and agile delivery models Identify the problem patterns and improve the technical design of the application/system Proactively identify issues/defects/flaws in module/requirement implementation Assists Lead 1 - Software Engineering on Technical design. Review activities and begin demonstrating Lead 1 capabilities in making technical decisions Typical performance measures: Adherence to engineering process and standards (coding standards) Adherence to schedule / timelines Adhere to SLAs where applicable Number of defects post delivery Number of non-compliance issues Reduction of reoccurrence of known defects Quick turnaround of production bugs Meet the defined productivity standards for project Number of reusable components created Completion of applicable technical/domain certifications Completion of all mandatory training requirements Performance Areas: Code: Develop code independently for the above Configure: Implement and monitor configuration process Test: Create and review unit test cases, scenarios and execution Domain relevance: Develop features and components with good understanding of the business problem being addressed for the client Manage Project: Manage module level activities Manage Defects: Perform defect RCA and mitigation Estimate: Estimate time, effort, resource dependence for one's own work and others' work, including modules Document: Create documentation for own work as well as perform peer review of documentation of others' work Manage knowledge: Consume and contribute to project related documents, share point, libraries and client universities Status Reporting: Report status of tasks assigned Comply with project related reporting standards/process Release: Execute release process Design: LLD for multiple components Skill Examples: Explain and communicate the design / development to the customer Perform and evaluate test results against product specifications Develop user interfaces, business software components and embedded software components 5 Manage and guarantee high levels of cohesion and quality 6 Use data models Estimate effort, and resources required for developing / debugging features / components Perform and evaluate test in the customer or target environment Team Player Good written and verbal communication abilities Proactively ask for help and offer help Knowledge Examples: Appropriate software programs / modules Technical designing Programming languages DBMS Operating Systems and software platforms Integrated development environment (IDE) Agile methods Knowledge of customer domain and sub domain where problem is solved Education/Experience Requirements Graduate in Engineering or MCA/Equivalent with 3 years of Software Engineering experience Graduate in Science/Commerce or BCA/Equivalent with 4 years of Software Engineering experience