Senior EDI Developer

We are looking for an experienced Senior EDI Developer with strong hands‑on expertise in the Healthcare Payer domain, Facets Claims, HIPAA X12 transactions, Edifecs, and Tri Zetto HIPAA Gateway
. The ideal candidate will have extensive experience designing, developing, testing, and supporting EDI integrations within a Facets-based healthcare payer environment
, with a primary focus on Claims processing and related workflows across Membership, Enrollment, Provider, and Payment. Candidates must demonstrate practical experience in EDI mapping, transaction validation, trading partner integrations, production support, and high‑volume transaction processing. Strong knowledge of HIPAA compliance, SQL, Unix/Linux, SFTP, and batch processing is essential.
Important: Hands‑on experience with Facets Claims is mandatory. Candidates with only general healthcare, provider‑side, or EDI experience without relevant Facets Claims exposure will not be considered suitable.

• Design, develop, enhance, and maintain healthcare EDI solutions using Edifecs, Tri Zetto HIPAA Gateway, Biz Talk Server, or equivalent platforms
  .
• Develop, configure, and optimize EDI maps, validation rules, routing logic, and transaction processing workflows.
• Implement and support HIPAA X12 transactions across Claims, Membership, Enrollment, Provider, and Payment domains.
• Work directly with Facets Claims integrations, supporting claims‑related EDI processing and downstream system interfaces.
• Develop and maintain trading partner integrations, including onboarding, connectivity, testing, certification, and production deployment.
• Implement EDI validation, error handling, acknowledgements, reconciliation, and exception management.
• Support high‑volume EDI transaction processing and optimize performance, reliability, and processing efficiency.
• Troubleshoot production issues, perform root cause analysis, and implement corrective and preventive measures.
• Work with SQL Server or Oracle databases to validate data, investigate issues, and support reconciliation.
• Develop and maintain batch processes, SFTP integrations, and Unix/Linux shell scripts.
• Support API‑based integrations and data exchange using XML, XSD, JSON, and related technologies.
• Collaborate with Facets teams, business analysts, QA, trading partners, and technical leads to deliver reliable integrations.
• Create technical documentation, low‑level designs, test cases, deployment plans, and support documentation.
• Participate in code reviews, testing, release management, and continuous improvement initiatives.
• Ensure adherence to HIPAA requirements, development standards, quality controls, and project SLAs.

• Healthcare Payer Domain: 5+ years of experience.
• EDI Development: 5+ years of hands‑on development experience.
• Edifecs Suite: 3+ years of experience with XEngine, Spec Builder, Trading Partner Management (TPM), and Validation & Compliance.
• Tri Zetto HIPAA Gateway: 3+ years of hands‑on experience.
• Facets: Mandatory hands‑on experience, specifically with Facets Claims
  .
• HIPAA X12 Transactions: Strong hands‑on experience in development, mapping, validation, and troubleshooting.
• Trading Partner Integrations: Experience implementing and supporting external trading partner interfaces.
• EDI Mapping and Validation: Experience developing maps, validation rules, acknowledgements, and exception‑handling workflows.
• Database Technologies: Working experience with SQL Server or Oracle.
• Unix/Linux: Experience with command‑line operations and troubleshooting.
• SFTP and Batch Processing: Experience supporting secure file transfers and scheduled EDI processing.
• API Integrations: Experience integrating EDI solutions with APIs and downstream systems.
• Technical…