EDI Developer (Healthcare / NEMT)

MediDrive, LLC; United States; Hybrid; USD 120,000 - 160,000; Full time

Benefits offered by this job

Remote-friendly environment

Job summary

MediDrive, LLC is seeking an EDI Developer to design, build, and support healthcare EDI integrations across claims and eligibility pipelines. The role requires strong .NET expertise, hands-on EdiFabric experience, and a deep understanding of healthcare workflows and companion guides.

You will manage end-to-end claims processes, including intake, validation, submission, remittance posting, and error resolution, while ensuring HIPAA security and data integrity in a microservices-based environment.

Qualifications

• 5+ years of healthcare EDI development experience.
• Strong proficiency in C# / .NET and EDI standards.
• Hands-on production experience with EdiFabric.
• Experience implementing payer companion guides.
• Understanding of HIPAA and secure data handling.
• Familiarity with Docker, Kubernetes, and CI/CD workflows.
• Experience with Medicaid / NEMT integrations is a plus.

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, 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.

Skills

5+ years healthcare EDI development

C# / .NET

EdiFabric

HIPAA compliance

Docker

Kubernetes

GitHub / CI/CD

Protobuf / gRPC

Tools

Docker

Kubernetes

GitHub

GitHub Actions

Protobuf

Job description

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.

Key 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

Required Qualifications

• 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

Strongly Preferred / Nice to Have

• 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

What We’re Looking For

We are not looking for a generic backend developer with light EDI exposure. This role requires someone who:

• 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

Why MediDrive

• 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