Demo

Lead EDI Specialist / Tester Medicaid & HIPAA X12

Sunrise Systems, Inc.
Raleigh, NC Contractor
POSTED ON 5/22/2026
AVAILABLE BEFORE 6/21/2026
Title: Lead EDI Specialist / Tester Medicaid & HIPAA X12 Job ID: 26-02464 Location: Dix Campus Raleigh, North Carolina Duration: 03 months of contract

Location: Local Candidates Only

Client is seeking a Lead EDI Specialist / Tester to support Medicaid Reform and Managed Care Transition projects. The ideal candidate should have strong experience in HIPAA X12 EDI transactions, EDI mapping, testing, and healthcare claims processing.

Key Responsibilities:
  • Develop and execute EDI/X12 test scripts and QA testing
  • Perform EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
  • Monitor inbound/outbound X12 transactions and troubleshoot EDI issues
  • Support trading partner setup, validation, and full-cycle testing
  • Collaborate with internal teams, vendors, and healthcare providers
  • Maintain EDI documentation, process flows, and reporting metrics

Required Skills:
  • 7 years of X12 EDI testing experience
  • Strong HIPAA X12 EDI transaction knowledge
  • Experience with healthcare claims, provider, and eligibility processing
  • Experience with Medicaid/MMIS environments preferred
  • Knowledge of Agile methodology and EDI issue resolution
  • Strong communication and stakeholder coordination skills.

Contact:
Raghu: | URL:

Hourly Wage Estimation for Lead EDI Specialist / Tester Medicaid & HIPAA X12 in Raleigh, NC
$33.00 to $44.00
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