Dahl Consulting is a healthcare services organization seeking a Senior Healthcare EDI & Integration Engineer. This role is responsible for leading healthcare data integrations, ensuring the reliability, security, and performance of EDI and API-based data flows that support claims, eligibility, enrollment, and reporting.
Responsibilities:
- Lead the assessment, planning, and execution of healthcare EDI implementations, including transactions such as 834, 835, 837, 270/271, and 276/277
- Gather, analyze, and document technical and business requirements in collaboration with internal stakeholders, clients, and vendors
- Develop and maintain standards-based interface specifications and implement data interfaces in accordance with business objectives
- Interpret EDI mapping guides, manage partner communications, and produce operational and technical documentation
- Publish and maintain FHIR APIs to support modern interoperability requirements
- Perform monthly member eligibility audits comparing inbound enrollment files to system data and report findings to leadership
- Serve as primary technical owner of claims and eligibility platforms, including file ingestion, transformation, and delivery pipelines
- Manage user access, security permissions, and system configurations in accordance with compliance and security policies
- Coordinate operating system patching, updates, and security hardening
- Monitor and manage daily processing of eligibility, claims, and provider files to ensure accuracy and timeliness
- Partner with infrastructure teams to ensure system availability, performance, and scalability
- Design, develop, and maintain automation scripts to support claims processing, eligibility workflows, and client-specific integrations
- Identify opportunities to reduce manual effort through automation and process optimization
- Lead technical onboarding for new clients, including SFTP configuration, file validation, test file processing, and automation setup
- Coordinate testing activities in lower environments and maintain test data
- Collaborate with client technical teams to ensure secure data exchange protocols
- Act as the primary technical contact for clearinghouses and technology vendors
- Troubleshoot issues across production and non-production environments
- Work closely with internal claims, operations, finance, and leadership teams to support audits, reporting, and issue resolution
- Monitor system health, alerts, and file transmissions to ensure uninterrupted operations
- Manage inbound and outbound EDI jobs, encryptions, transfers, and conversions
- Troubleshoot EDI, API, and file transfer issues and manage support tickets to resolution
- Maintain and test SFTP connections
- Support SOC, HIPAA, and internal audits by providing technical evidence and documentation
- Ensure compliance with HIPAA, data security standards, and internal IT policies
- Develop and maintain comprehensive technical documentation covering architecture, data flows, and client-specific integrations
- Partner with IT leadership to develop and maintain disaster recovery procedures
- Participate in regular disaster recovery testing and document recovery steps for critical systems
Requirements:
- 4+ years of experience in IT operations, systems engineering, or integration engineering
- 2+ years of hands-on healthcare EDI experience within a payer, TPA, or healthcare services organization
- 2+ years supporting application platforms in a production environment
- Expertise with EDI transactions, including: 837 (Claims), 835 (Remittance Advice), 834 (Enrollment), 270/271 (Eligibility), 276/277 and 999 (Claim Status and Acknowledgments)
- 2+ years of experience working with AWS infrastructure, including S3, Transfer Family, Lambda, and SFTP configurations
- Experience managing and publishing FHIR APIs with a strong understanding of FHIR standards and profiles
- Experience developing or supporting RESTful APIs using languages such as Python, Java, or .NET
- Proficiency in scripting and automation using languages such as Python, PowerShell, or Bash
- Experience with secure file transfer protocols and healthcare data exchange standards
- Familiarity with healthcare clearinghouses and claims staging processes
- Working knowledge of Windows and Linux operating systems
- Strong troubleshooting, analytical, and problem-solving skills
- Excellent written and verbal communication skills, including the ability to explain technical concepts to non-technical stakeholders
- Knowledge of HIPAA regulations and secure handling of protected health information (PHI)
- Ability to manage multiple priorities with limited direction
- Experience supporting healthcare payer or third-party administrator systems
- Experience supporting SOC, HIPAA, or internal IT audits
- Familiarity with claims adjudication workflows and benefits administration platforms
- Experience collaborating closely with external vendors and client technical teams