Edifecs Technical Lead

• 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.

• 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.