EDI Developer
About The Position
The X12 EDI Developer is responsible for designing, developing, and maintaining HIPAA-compliant EDI solutions, integrations, and supporting applications that facilitate secure and efficient data exchange across CHCN and its external trading partners. This role programs and monitors EDI workflows using T‑SQL, third-party tools, and web-based technologies (VB.NET, C#, REST APIs). The developer ensures the accuracy, reliability, and compliance of critical healthcare data exchanges—including eligibility, encounters, claims, and remittance—while supporting operational excellence and continuous improvement across CHCN.
Requirements
- A Bachelor’s degree in Computer Science or a related field, and 1 year of experience in an information technology role.
- T-SQL programming on Microsoft SQL Server.
- Web application development using VB.NET, C#, JavaScript, NodeJS, TypeScript, and Python.
- Knowledge of X12 transaction structures, loops, segments, and SNIP (Strategic National Implementation Process [https://www.google.com/search?q=Workgroup+for+Electronic+Data+Interchange+%28WEDI%29+Strategic+National+Implementation+Process&rlz=1C1OKWM_enUS1197US1197&oq=SNIP+validation+stands+for&gs_lcrp=EgZjaHJvbWUyBggAEEUYOTIHCAEQIRigATIHCAIQIRigATIHCAMQIRigATIHCAQQIRiPAtIBCTY1MDNqMGoxNagCCLACAfEF2YEz5SlV-E7xBdmBM-UpVfhO&sourceid=chrome&ie=UTF-8&mstk=AUtExfAlF1T3ZdThXRHNfkPdu6esKt-s0LEDe0_Z0kAgVP_W41IMvoJwm-gYVUOfA8BlzrOFXUayLrlRju6cnIwxd_jS5wa-gpXqjg_w3-R0JMHKZ3mbKqEvaochoTVqq9efGHA&csui=3&ved=2ahUKEwjy36bmyJ2TAxWeGTQIHSz3LtsQgK4QegQIARAC]) validation.
- Design, development, and troubleshooting of ETL transactions, particularly with HIPAA ANSI, X12, ADT, CCD, or HL7.
Responsibilities
- Develop and maintain EDI processes for exchanging information with health plans, providers, HMOs, health centers, and clearinghouses, and collaborate on onboarding, connection setup, testing, and compliance activities.
- Develop and maintain HIPAA‑compliant EDI and ETL processes, including mapping, transformations, and envelope structures for X12 5010 transactions (837, 835, 834, 277/277CA, 278, 270/271, 274).
- Automate secure file transfers using SFTP/FTP between internal systems and external partner systems to streamline data exchange.
- Develop and maintain web-based applications and internal tools using C#, VB.NET, JavaScript, Node.js, TypeScript, Python,and REST API technologies to support EDI workflows and related databases.
- Create reconciliation and validation reporting mechanisms to ensure completeness, accuracy, and timeliness of data exchanges.
- Support daily EDI operations, including eligibility loads, encounter submissions, claims processing, and remittance workflows.
- Monitor inbound and outbound file exchanges to ensure timely processing and identify potential issues with data format or connectivity.
- Analyze and interpret business requirements and workflow processes to provide practical automated solutions in a complex environment within the EZ-CAP application and its databases.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
11-50 employees
