Senior Healthcare EDI Support Specialist

Cynet Systems•Seattle, WA

13h

About The Position

Seeking a Senior EDI Support Specialist with strong Healthcare Payer experience to provide L2/L3 support for enterprise EDI platforms supporting Claims, Membership, Enrollment, Provider, and Payment functions. The role requires expertise in HIPAA X12 transaction support, production monitoring, incident resolution, trading partner management, and Edifecs/TriZetto HIPAA Gateway environments.

Requirements

Healthcare Payer Domain (5+ years).
EDI Support (L2/L3) (5+ years).
HIPAA X12 Transactions (5+ years).
Facets (3+ years).
Edifecs Suite (3+ years).
TriZetto HIPAA Gateway (3+ years).
Trading Partner Management (3+ years).
BizTalk Server.
SQL Server or Oracle.
Unix/Linux.
SFTP, Batch Processing, and API Integrations.
XML/XSD and JSON.
Hands-on support, troubleshooting, and optimization of: 834 Enrollment Transactions.
837 Claims Transactions (Professional, Institutional, Dental).
835 Claims Payment.
270/271 Eligibility.
276/277 Claim Status.
278 Prior Authorization.
820 Premium Payment.
TA1, 999, and 277CA Acknowledgements.

Nice To Haves

HL7/FHIR.
ServiceNow.
MuleSoft, Boomi.
Groovy, JavaScript, PowerShell, Shell Scripting.
Large-scale Facets payer environments.

Responsibilities

Provide L2/L3 support for EDI platforms supporting Claims, Membership, Enrollment, Billing, Provider, and Payment functions.
Monitor, troubleshoot, and resolve EDI transaction failures, rejects, reconciliation, and file transmission issues.
Support Edifecs, TriZetto HIPAA Gateway, BizTalk, and Facets-integrated environments.
Perform root cause analysis (RCA), incident resolution, and transaction performance improvements.
Support trading partner onboarding, certification, testing, and production releases.
Work with business users, vendors, and external trading partners to resolve operational issues.

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