EDI/Integration Edifecs Developer (Remote/Hybrid Option)

Competitive Compensation & Benefits Package!

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs

Primary Purpose of Position:

The EDI/Integration Edifecs Developer codes software applications based on business requirements. The EDI/Integration Edifecs Developer work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The EDI/Integration Edifecs Developer standardizes the quality assurance procedure for software. Oversees testing and debugging and develops fixes. Research complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues. Understands department/programs and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Role and Responsibilities:

• Manage data transformation processes to handle EDI transactions and healthcare-specific formats (e.g., HL7, X12).
• Ensure accurate data mapping and transformation within containerized applications.
• Monitor deployed EDI applications' performance, health, and resource utilization.
• Proactively identify and resolve issues to maintain high availability and reliability of the deployed software.
• Work with cross-functional teams to integrate applications using APIs and EDI to various systems.
• Ensure seamless data exchange between applications and external partners.
• Work closely with cross-functional teams to automate build and deployment of EDI applications
• Conduct testing and validation to ensure functionality, data accuracy, and interoperability
• Perform load testing to evaluate system performance under heavy workloads
• Maintains active relationships with external partners, the State and vendors to build and maintain EDI workloads
• Participates in gathering requirements, installing, configuring and overseeing the implementation of EDIFECS.
• Interface with the internal business and technical resources as needed.
• Design, build, and test payer EDI systems including but not limited to the processing of claims and encounters.
• Working with an established and dynamic DevOps team that includes outside vendor personnel and remote project team members.

Knowledge, Skills and Abilities:

• Experience with Object Oriented and Functional design and development.
• Experience with Agile development practices.
• Experience with high performance/high volume batch processing applications.
• Experience with backend development using Java or Golang.
• Experience with microservices architecture (APIs, Events, Observability).
• Experience with EDI (x12 HIPAA transactions), FHIR is plus.
• Experience with Edifecs tools (xEngine, XEServer, EAM, SpecBuilder, TM).
• Experience with DevOps and/or Jira
• Experience with processing Encounters and Claims

Education/Experience Required:

• Bachelor’s degree in Information Technology, Computer Science or related field or equivalent work experience required.
• 5-8 years of hands on Edifecs/EDI development experience.
• Experience working directly in a Healthcare payer or healthcare providers EDI solution that involves upgrades or migration of EDI technologies.
• Experience with requirements gathering, design, and mapping EDI X12 276/277 claims status and claims response, EDI X12 834 member enrollment, EDI X12 835 claims payment and remittance and EDI X12 837 electronic claims transactions.
• Experience with Healthcare Electronic Data Interchange (EDI) mapping and EDI analysis.
• Experience using Edifecs toolset, Edifecs SpecBuilder, Edifecs MapBuilder, Edifecs XEngine, Edifecs XEngine Server, Edifecs Transactions Management, Edifecs, Trading Partner Management Edifecs Application Manager (EAM), Edifecs GBD repository, HIPAA X12, Unix/Linux Java Understanding of EDI Transactions.
• Experience working in Edifecs 8.4 or newer

Education/Experience Preferred:

• 2+ years Encounters processing within the state of NC.