Senior EDI Claims Data Engineer (HIPAA X12)

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

Job summary

NationsBenefits is seeking an experienced Senior Data Engineer – EDI Claims Processing to design and maintain enterprise healthcare data integrations focused on HIPAA X12 EDI, Medicaid encounters, and CMS compliance. You will lead ingestion, validation, and delivery pipelines and collaborate with cross-functional teams to ensure accurate claims submissions.

The role emphasizes scalable ETL/ELT development using Databricks, PySpark, Delta Lake, and SQL Server, with a strong focus on security and

Qualifications

• Bachelor's degree in CS/IT/Engineering or equivalent.
• 5–8+ years as a Data Engineer, Integration Engineer, or Healthcare Data Engineer.
• Strong experience with HIPAA X12 EDI, including 837, 277CA, 999, 834, 835.
• Medicaid encounters processing and CMS regulatory updates.
• Proficiency with Databricks, PySpark, Delta Lake, and SQL Server.
• Experience with healthcare clearinghouses and EDI tools.

Responsibilities

• Design, develop, and maintain HIPAA EDI pipelines (837, 277CA, 999, 834, 835).
• Build scalable ETL/ELT workflows using Databricks and SQL Server.
• Manage Medicaid encounter submissions and CMS regulatory updates.
• Develop validation frameworks for HIPAA compliance and SNIP checks.
• Collaborate with Claims Ops, Compliance, IT Security, and partners.
• Create monitoring, logging, and SLA reporting for production workflows.

Skills

Databricks

PySpark

Delta Lake

SQL Server

HIPAA X12 EDI

Medicaid Encounters

CMS Encounter Processing

Azure Databricks

EDI Mapping

Data Validation

Education

Bachelor's degree in CS/IT/Engineering

Tools

Azure Databricks

HIPAA Suite

Job description

NationsBenefits is seeking an experienced Senior Data Engineer – EDI Claims Processing to design and maintain enterprise healthcare data integrations focused on HIPAA X12 EDI, Medicaid encounters, and CMS compliance. You will lead ingestion, validation, and delivery pipelines and collaborate with cross-functional teams to ensure accurate claims submissions.

The role emphasizes scalable ETL/ELT development using Databricks, PySpark, Delta Lake, and SQL Server, with a strong focus on security and