What are the responsibilities and job description for the EDI Developer position at STAFFXPERT LLC?
Job Title: EDI Developer
Work Schedule: Hybrid 3 Days Onsite / 2 Days Remote (Local Candidates Only)
Interview Process: Virtual Interview
Position Overview
STAFFXPERT is seeking an experienced Senior EDI Developer/EDI Subject Matter Expert to support, maintain, and modernize the ACAPS healthcare claims processing system. The selected consultant will be responsible for the complete lifecycle of healthcare claims processing, including EDI transaction management, claims adjudication support, provider onboarding, troubleshooting, documentation, and collaboration with technical and business teams during the migration of ACAPS to a .NET platform.
The ideal candidate will possess strong healthcare EDI experience, in-depth knowledge of HIPAA regulations, claims processing expertise, SQL/database skills, and the ability to work independently while supporting both internal stakeholders and external healthcare partners.
Must Have Skills
Work Schedule: Hybrid 3 Days Onsite / 2 Days Remote (Local Candidates Only)
Interview Process: Virtual Interview
Position Overview
STAFFXPERT is seeking an experienced Senior EDI Developer/EDI Subject Matter Expert to support, maintain, and modernize the ACAPS healthcare claims processing system. The selected consultant will be responsible for the complete lifecycle of healthcare claims processing, including EDI transaction management, claims adjudication support, provider onboarding, troubleshooting, documentation, and collaboration with technical and business teams during the migration of ACAPS to a .NET platform.
The ideal candidate will possess strong healthcare EDI experience, in-depth knowledge of HIPAA regulations, claims processing expertise, SQL/database skills, and the ability to work independently while supporting both internal stakeholders and external healthcare partners.
Must Have Skills
- 5 years of Electronic Data Interchange (EDI) experience
- 5 years of Healthcare EDI transaction experience (837, 835, 210)
- 5 years of Database/SQL experience
- Strong understanding of HIPAA regulations and healthcare compliance
- Experience with Healthcare Claims Processing and Claims Adjudication
- Experience troubleshooting EDI file transmissions and data exchange issues
- Ability to create and maintain technical documentation and specifications
- Experience with system testing, validation, and production support
- Strong analytical, verbal, and written communication skills
- Experience working directly with healthcare providers and external trading partners
- Ability to work independently with minimal supervision
- Bachelor's degree in Computer Science, Information Technology, or a related field
- Healthcare / Health Insurance industry experience
- IBM WebSphere Transformation Extender (WTX)
- .NET application modernization or migration experience
- Provider and Clearinghouse onboarding experience
- Advanced SQL and database administration skills
- Medicaid/Medicare claims processing experience