EDI Developer (Healthcare / NEMT)
Corporate Transportation Group
•Remote
About The Position
The EDI Developer will be responsible for designing, building, maintaining, and supporting healthcare EDI integrations across multiple transaction types. This role requires strong .NET expertise, hands-on experience with EdiFabric, and a deep understanding of healthcare claims workflows, payer companion guides, and real-world EDI behavior. Experience with Non-Emergency Medical Transportation (NEMT) is a significant advantage, as many integrations involve transportation-specific billing logic, modifiers, and state Medicaid requirements.
Requirements
- 5+ years of healthcare EDI development experience
- Strong proficiency in C# / .NET
- Hands-on production experience with EdiFabric
- Deep understanding of healthcare EDI standards and workflows: X12 structure, loops, segments, and qualifiers; Claims lifecycle and remittance processing
- Proven experience implementing payer companion guides
- Strong troubleshooting skills for real-world EDI issues (payer rejections, inconsistencies, edge cases)
- Solid understanding of HIPAA and secure data handling practices
- Understands how healthcare claims actually flow end-to-end
- Can read and implement companion guides without hand-holding
- Has dealt with inconsistent payer behavior in production
- Is comfortable owning EDI workflows from ingestion through reconciliation
Nice To Haves
- NEMT industry experience (major plus)
- Experience with Medicaid and managed care plans
- Hands-on experience with: Docker, Docker Compose, Kubernetes
- Familiarity with: GitHub, GitHub Actions (CI/CD pipelines)
- Exposure to microservices architectures
- Familiarity with Protobuf / gRPC
- Experience deploying and operating backend services in cloud environments
Responsibilities
- Design, implement, and maintain healthcare EDI pipelines using .NET and EdiFabric
- Parse, validate, generate, and troubleshoot EDI transactions, including: 834 – Eligibility / Enrollment, 837 (P / I / D) – Healthcare Claims, 835 – Remittance Advice, 270/271, 999, 277CA
- Interpret and implement payer-specific companion guides
- Manage end-to-end claims workflows: Intake, validation, and submission; Acknowledgments (999, 277CA); Remittance processing and posting (835); Error handling, corrections, and resubmissions
- Build and maintain robust logging, auditing, and reconciliation processes
- Collaborate with product, operations, and external partners (health plans and transportation providers)
- Ensure HIPAA-compliant data handling and monitoring
- Contribute to and operate within a microservices-based architecture
Benefits
- Work on real, high-volume healthcare and Medicaid integrations
- Senior-level ownership and autonomy
- Modern, containerized architecture
- Remote-friendly environment
- Opportunity to shape the EDI foundation of a growing NEMT platform
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
Number of Employees
11-50 employees
