EDI Integration Specialist

TechDigital Group; United States; Remote; USD 80,000 - 110,000; Full time

Job summary

A healthcare integration solutions company is seeking an experienced Integration Specialist to design and maintain integration solutions using EDI standards. Candidates should have at least 5 years of experience in the healthcare industry, focusing on EDI transactions and compliance with HIPAA. This role requires strong troubleshooting skills and the ability to collaborate with various teams to ensure seamless data exchange.

Qualifications

• 5+ years of experience in integration development, focusing on EDI in healthcare.
• Proficient in HIPAA X12 and HL7 healthcare EDI standards.
• Strong knowledge of integration tools and XML, JSON, SQL.

Responsibilities

• Design and maintain integration solutions for healthcare data exchange.
• Implement and support EDI transactions such as 837, 835.
• Collaborate with teams to gather requirements for integration solutions.

Skills

EDI expertise

Healthcare domain standards

Troubleshooting skills

Communication

Collaboration

Education

Bachelor's degree in Computer Science or related field

Tools

MuleSoft

Dell Boomi

Cloverleaf

IBM Sterling Integrator

BizTalk

Job description

Overview

External facing experience is MUST. We are seeking a skilled Integration Specialist with strong Electronic Data Interchange (EDI) expertise and a solid understanding of healthcare domain standards to design, develop, and maintain integration solutions. This role will focus on implementing, testing, and supporting EDI transactions, ensuring compliance with HIPAA and healthcare industry standards.

Key Responsibilities

• Design, develop, and maintain integration solutions for healthcare data exchange using EDI standards (e.g., X12, HL7).
• Implement, configure, and support EDI transactions such as 837 (claims), 835 (remittance), 270/271 (eligibility), 276/277 (claim status).
• Work with healthcare partners, payers, and providers to troubleshoot and resolve integration issues.
• Develop mapping, translation, and transformation processes between internal systems and external partners.
• Ensure compliance with HIPAA, security protocols, and industry data exchange requirements.
• Collaborate with business analysts, QA teams, and project managers to gather requirements and deliver high-quality integration solutions.
• Monitor integration processes and proactively identify performance or data issues.
• Maintain detailed technical documentation and provide training or knowledge transfer to internal teams.

Required Skills & Qualifications

• Bachelor's degree in Computer Science, Information Technology, or related field (or equivalent experience).
• 5+ years of experience in integration development, with a strong focus on EDI in the healthcare industry.
• Proficiency in healthcare EDI standards (HIPAA X12, HL7).
• Hands-on experience with integration tools (e.g., MuleSoft, Dell Boomi, Cloverleaf, IBM Sterling Integrator, BizTalk, or similar).
• Strong knowledge of healthcare processes including claims, eligibility, payments, and prior authorizations.
• Solid understanding of XML, JSON, SQL, REST, and SOAP-based web services.
• Strong troubleshooting and problem-solving skills.
• Excellent communication and collaboration abilities.

Preferred Qualifications

• Experience with cloud-based integration platforms (e.g., Azure Logic Apps, AWS Step Functions, or GCP integrations).
• Knowledge of FHIR (Fast Healthcare Interoperability Resources) standards.
• Previous work with payer or provider systems.
• Familiarity with agile development methodologies.