Senior Data Engineer - EDI & Health Claims

NationsBenefits, LLC; Plantation (FL); On-site; USD 120,000 - 180,000; Full time

Job summary

NationsBenefits, located in Plantation, FL, is seeking a Senior Data Engineer – EDI Claims Processing to design, develop, and maintain enterprise-scale healthcare data integration solutions focused on HIPAA X12 EDI transactions, Medicaid encounters, and CMS compliance.

The role requires strong experience with Databricks, PySpark, Delta Lake, and SQL Server, plus hands-on work with Medicaid submissions and regulatory updates to ensure secure, compliant data processing across partners.

Qualifications

• Bachelor's degree in CS/IT/Engineering or related field.
• 5–8+ years as a Data/Integration Engineer in healthcare.
• Proficiency with HIPAA X12 EDI standards (837, 277CA, 999, 834, 835).
• Experience with Medicaid encounters and CMS regulations.
• Strong experience with Databricks, PySpark, Delta Lake, and SQL Server.
• Knowledge of HIPAA, PHI security, SNIP validation, and EDI mapping.

Responsibilities

• Design, build, and optimize HIPAA X12 data pipelines for claims processing.
• Handle Medicaid encounter processing and state submissions.
• Implement CMS encounter regulations, schema updates, and compliance changes.
• Develop automated validation and data quality checks for HIPAA compliance.
• Maintain monitoring, logging, and SLA reporting for production EDI workflows.
• Collaborate with Claims Ops, Compliance, Product, IT Security and partners to support data integration.

Skills

Ownership mindset

Communication skills

Collaboration

Education

Bachelor's degree in Computer Science or related field

Tools

Databricks

PySpark

Delta Lake

SQL Server

T-SQL

Azure Databricks

HIPAA Suite

Job description

NationsBenefits, located in Plantation, FL, is seeking a Senior Data Engineer – EDI Claims Processing to design, develop, and maintain enterprise-scale healthcare data integration solutions focused on HIPAA X12 EDI transactions, Medicaid encounters, and CMS compliance.

The role requires strong experience with Databricks, PySpark, Delta Lake, and SQL Server, plus hands-on work with Medicaid submissions and regulatory updates to ensure secure, compliant data processing across partners.