Pega SSA Developer

TechDigital Group; Oklahoma; Hybrid; USD 110,000 - 160,000; Full time

Job summary

TechDigital Group seeks a seasoned Pega Developer to design, develop, and configure Pega applications for healthcare claims processing, with tight integration to Facets. You will work on Claims, Membership, Billing, and Provider modules to support end-to-end lifecycle management.

The role requires translating HIPAA and X12 transactions into robust Pega designs, building flows and UI rules, and collaborating with BAs, architects, and QA teams to ensure high-quality solutions.

Qualifications

• 10+ years of Pega development experience for healthcare claims.
• Design, develop, and configure Pega apps with Facets integration.
• Ability to collaborate with business analysts, architects, and QA teams.

Responsibilities

• Design, develop, and configure Pega applications for healthcare claims processing with Facets.
• Work on Facets modules (Claims, Membership, Billing, Provider) for end-to-end lifecycle.
• Build Pega case types, flows, rules, and UI to automate claims handling.
• Integrate Pega with Facets and core systems via REST/SOAP APIs.
• Translate HIPAA, EDI 837/835 into Pega design.

Skills

Pega platform

Facets integration

REST/SOAP APIs

Healthcare claims

Business analysis

Cross-functional collaboration

Pega flows

Tools

Facets

Job description

Job Description:

• Pega Developer with experience in Designing, developing and configuring Pega applications for Healthcare Claims processing. Skilled in building flows in Pega, integrating with application called Facets and analyzing and translating the business requirements.


• Experienced in collaborating with business analysts, architects, and QA teams to deliver high quality applications.

1. Design, develop, and configure Pega applications for healthcare claims processing, adjudication, and workflow automation integrated with Facets.


2. Work on Facets modules (Claims, Membership, Billing, Provider) to support end-to-end claims lifecycle management including intake, adjudication, and payment processing.


3. Build and customize Pega case types, flows, decision rules, and UI rules to automate claims exception handling and manual review processes.


4. Integrate Pega with Facets and other core administration systems using REST/SOAP APIs, connectors, and data pages.


5. Analyze and translate healthcare claims business requirements (HIPAA, EDI 837/835, X12 transactions) into Pega application design.

Years of Experience: 10+ Years of Experience