Senior EDI Developer

Job Title: EDI Developer / EDI Expert

Location: Indianapolis, IN USA

Duration: 5 months

Job Description:

The Indiana Department of Health (IDOH) is seeking an experienced EDI Expert to support and enhance its healthcare claims processing system (ACAPS). The selected candidate will be responsible for maintaining EDI transaction processing, healthcare claims adjudication workflows, provider integrations, and supporting modernization efforts as the ACAPS system is rewritten in .NET.

Required Qualifications:

• Bachelor''s Degree in Computer Science or related field with IT experience

• 5 years of database experience (SQL preferred)

• 5 years of experience working with EDI transactions and file formats including:

  • 835 (Healthcare Claim Payment/Advice)

  • 837 (Healthcare Claim Submission)

  • 210 (Motor Carrier Freight Details and Invoice)

• Strong understanding of HIPAA regulations and healthcare data compliance

• Experience troubleshooting complex EDI processing and transmission issues

• Excellent verbal and written communication skills

Preferred Qualifications:

• Healthcare industry experience

• IBM WebSphere Transformation Extender (WTX) experience

• Healthcare claims processing experience

• Database and SQL development/support experience

Key Responsibilities:

• Maintain and support healthcare EDI transaction processing

• Review, update, and create documentation for claims processing workflows

• Serve as Subject Matter Expert (SME) for EDI and claims processing during system modernization efforts

• Collaborate with project managers, developers, business analysts, and business stakeholders

• Develop technical specifications from business requirements

• Test new and existing applications and integrations

• Monitor and resolve EDI transmission and file exchange issues with external trading partners

• Provide support for healthcare providers and clearinghouses

• Assist with onboarding new providers and clearinghouse partners

• Support claims adjudication and pricing workflows

• Work independently while coordinating with internal and external stakeholders

Technical Environment:

• EDI Transactions (835, 837, 210)

• HIPAA Compliance

• SQL / Database Systems

• Healthcare Claims Processing

• IBM WebSphere (WTX) Preferred

• .NET Modernization Environment

Note: Local candidates only. Sponsorship is not available for this position.