About this role
Our client is seeking an experienced EDI Developer to join their team. The EDI Developer will be responsible for managing the life cycle of claims received from health providers, ensuring they are accurately loaded into the database, adjudicated according to state and national pricing standards, and that adjudication messages are effectively communicated back to the originating provider.
Key Responsibilities:
- Maintain and oversee the life cycle of health claims from receipt to adjudication.
- Collaborate with project managers, software developers, business analysts, and functional team members on project activities.
- Review and update all EDI-related documentation and processes.
- Troubleshoot and resolve any issues related to EDI transactions and data integrity.
- Ensure compliance with relevant regulations and standards in the EDI process.
Required Skills & Qualifications:
- Strong experience with EDI standards such as ANSI X12.
- Proficiency in EDI mapping and translation tools.
- Familiarity with healthcare claims processing and adjudication.
- Knowledge of database management and SQL.
- Excellent communication and collaboration skills.
Experience:
- Minimum of 5-8 years of experience in EDI development or related fields.
What we offer:
- Opportunity to work in a dynamic environment with a collaborative team.
- Professional development and growth opportunities.
- Engaging projects that make a difference in the healthcare industry.
This role is managed by AI-First Talent on behalf of our client. Your application is reviewed directly by our talent team.