EDI Specialist

Role - EDI Specialist
Location - Seattle, WA
12+ Months

Summary:

Seeking a Senior EDI Support Specialist with strong Healthcare Payer experience to provide L2/L3 support for enterprise EDI platforms supporting Claims, Membership, Enrolment, Provider, and Payment functions. The role requires expertise in HIPAA X12 transaction support, production monitoring, incident resolution, trading partner management, and Edifecs/TriZetto HIPAA Gateway environments.

Responsibilities

• Provide L2/L3 support for EDI platforms supporting Claims, Membership, Enrolment, Billing, Provider, and Payment functions. Monitor, troubleshoot, and resolve EDI transaction failures, rejects, reconciliation, and file transmission issues.
• Support Edifecs, TriZetto HIPAA Gateway, BizTalk, and Facets-integrated environments. Perform RCA, incident resolution, and transaction performance improvements. Support trading partner onboarding, certification, testing, and production releases.
• Work with business users, vendors, and external trading partners to resolve operational issues. Required Skills Edifecs Suite, TriZetto HIPAA Gateway, BizTalk Server Facets SQL Server/Oracle Unix/Linux SFTP, Batch Processing, API Integrations XML/XSD, JSON

Required Experience

• Healthcare Payer Domain 5+ Years
• EDI Support (L2/L3) 5+ Years
• HIPAA X12 Transactions 5+ Years
• Facets 3+ Years
• Edifecs Suite 3+ Years
• TriZetto HIPAA Gateway 3+ Years
• Trading Partner Management 3+ Years
• 834 Enrollment Transactions Must Have
• 837 Claims Transactions (P/I/D) Must Have
• 835 Claims Payment Must Have
• 270/271 Eligibility Must Have
• 276/277 Claim Status Must Have
• 278 Prior Authorization Must Have
• 820 Premium Payment Must Have
• TA1 / 999 / 277CA Acknowledgements Must Have
• SQL Server or Oracle Must Have
• Unix/Linux Must Have
• SFTP & Batch Processing Must Have
• XML/XSD & JSON Must Have

In compliance with the salary transparency law, the expected pay range for this role is $60/hr Actual compensation depends on experience and interview evaluation.