Senior EDI Developer (Healthcare Payer - Facets Ecosystem)

Saransh Inc; Seattle (WA); On-site; USD 96,000 - 165,000; Full time

Benefits offered by this job

On-site role in Seattle

Job summary

Saransh Inc is seeking a Senior EDI Developer with deep healthcare payer and Facets ecosystem experience to design, develop, and optimize HIPAA X12 integrations. Hands-on work with Edifecs/TriZetto HIPAA Gateway, EDI mappings, and trading partner integrations across Claims, Membership, Enrollment, Provider, and Payment domains.

The role requires expertise in Edifecs/TriZetto HIPAA Gateway, Facets, and related technologies, with on-site collaboration in Seattle.

Qualifications

• 8+ years in IT with healthcare payer and EDI experience
• Hands-on with Edifecs/TriZetto HIPAA Gateway
• Experience with Facets-Claims and HIPAA X12 mappings

Responsibilities

• Design, develop, and optimize EDI solutions using Edifecs, TriZetto HIPAA Gateway, BizTalk, or equivalent platforms.
• Develop EDI mappings, validations, routing logic, and trading partner integrations.
• Implement and support HIPAA X12 transactions across Claims, Membership, Enrollment, Provider, and Payment domains.
• Optimize EDI maps and support high-volume transaction processing.
• Support trading partner onboarding, testing, certification, and production deployments.
• Collaborate with Facets and business teams to deliver EDI enhancements and integrations.

Skills

Edifecs XEngine

SpecBuilder

Trading Partner Management

Validation & Compliance

TriZetto HIPAA Gateway

Facets

SFTP

Unix/Linux

XML/XSD

JSON

API integrations

SQL Server

Oracle

Tools

BizTalk Server

Job description

Role: Senior EDI Developer: Healthcare Payer (Facets Ecosystem)

Location: Seattle, WA (Onsite from Day 1)

Job Type: Contract

Experience

• 8+ years in IT, 5+ years in healthcare payer and EDI, 3+ years with Edifecs or TriZetto HIPAA Gateway
• Need candidates with Facets - Claims experience

Role Overview

• We are looking for a Senior EDI Developer with strong healthcare payer experience to design, develop, and optimize HIPAA X12 integrations within a Facets-based ecosystem.
• The role requires hands-on expertise in Edifecs/TriZetto HIPAA Gateway, EDI mapping, trading partner integrations, and high-volume transaction processing across Claims, Membership, Enrollment, Provider, and Payment domains.

Key Responsibilities

• Design, develop, and optimize EDI solutions using Edifecs, TriZetto HIPAA Gateway, BizTalk, or equivalent platforms.
• Develop EDI mappings, validations, routing logic, and trading partner integrations.
• Implement and support HIPAA X12 transactions across Claims, Membership, Enrollment, Provider, and Payment domains.
• Optimize EDI maps and support high-volume transaction processing.
• Support trading partner onboarding, testing, certification, and production deployments.
• Collaborate with Facets and business teams to deliver EDI enhancements and integrations.

Required Skills

• Edifecs Suite: XEngine, SpecBuilder, Trading Partner Management, Validation & Compliance
• TriZetto HIPAA Gateway and BizTalk Server
• Facets
• SQL Server / Oracle
• Unix/Linux
• SFTP, batch processing, and API integrations
• XML/XSD and JSON

Required Experience

Hands-on development and optimization of the following transactions:

• 834 (Enrollment)
• 837 (Professional, Institutional, Dental)
• 835 (Remittance)
• 270/271 (Eligibility)
• 276/277 (Claim Status)
• 278 (Authorization)
• 820 (Premium Payment)
• TA1, 999, and 277CA acknowledgements

Nice To Have

• HL7 / FHIR
• MuleSoft or Boomi
• Groovy, JavaScript, PowerShell, or shell scripting
• Blues plan experience