Senior EDI Developer

The EDI Expert will manage the full lifecycle of healthcare claims as they move through intake, database processing, adjudication, and outbound response generation. The role involves working closely with project managers, developers, business analysts, and functional teams to support system modernization and ensure accurate EDI transactions aligned with state and federal healthcare standards.

Required Skills & Qualifications

• Bachelor s degree in Computer Science or related IT field
• 5+ years of database experience
• 5+ years of experience with EDI file formats (835, 837, 210)
• Strong understanding of HIPAA regulations
• Strong troubleshooting and problem-solving skills
• Excellent verbal and written communication skills

Preferred Skills

• Healthcare industry experience
• IBM WebSphere (WTX) experience
• SQL / Database development experience

Key Responsibilities

• Maintain and update documentation for claims processing and EDI transactions
• Identify gaps in existing EDI processes and document improvements
• Act as SME for ACAPS system modernization (.NET rewrite project)
• Serve as liaison between technical teams and business/program stakeholders
• Translate business requirements into detailed technical specifications
• Perform system testing for new and existing applications
• Ensure accurate EDI file exchange with trading partners and resolve transmission issues
• Provide helpdesk-level support for EDI claims transactions
• Support healthcare providers using IDOH systems
• Assist with onboarding new providers and clearinghouses
• Collaborate with internal and external partners independently when required