Technical Lead - Edifecs
Role: - Technical Lead - Edifecs Experience: - 7+ Years Location: - Remote Responsibilities: - Design, develop, and maintain EDI solutions using Edifecs (XEngine, Specbuilder, Transaction Management, or equivalent) for inbound and outbound 837P, 837I, and 837D transactions. Build and configure HIPAA X12 validation rules, including SNIP levels 1-7, and implement custom payer-specific business rules. Develop maps and transformations between X12 and internal formats (XML, JSON, flat files, database structures). Create and maintain trading partner profiles, companion guides, and partner-specific configurations. Analyze 837 implementation guides (5010) and translate requirements into technical designs. Process and reconcile related transactions such as 999/TA1 acknowledgments, 277CA claim acknowledgments, 835 remittances, and 276/277 claim status. Educational Qualifications: - Engineering Degree BE/ME/BTech/MTech/BSc/MSc. Technical certification in multiple technologies is desirable. Mandatory skills: - Hands-on experience with Edifecs Smart Trading Platform (XEngine, Specbuilder, Transaction Management) Strong understanding of US healthcare claims workflows (submission, adjudication, rejections/denials, remittance) and terminology such as payer, provider, clearinghouse, ICD-10, CPT/HCPCS, and NPI. Proficiency in SQL (Oracle, SQL Server, or PostgreSQL) for data analysis and troubleshooting. Experience with XML/XSD, XSLT, and flat-file and delimited-file formats. Strong analytical, debugging, and problem-solving skills. Good to have: Edifecs certification, HIPAA/EDI certification (e.g., X12 or AHIMA/HIMSS-related), or relevant healthcare IT training.