Edifecs EDI Analyst Transaction Specialist

The SW Engineer Principal (Edifecs EDI Analyst Transaction Specialist) owns functional EDI workflows, partner requirements, and data validation rules. This role ensures accurate transaction processing and supports business operations. This is a 100% Remote role.

JOB DESCRIPTION

- Interpret and troubleshoot transaction sets: 270/271, 276/277, 278, 820, 834, 835, 837, 999/277CA.

- Analyze SNIP compliance, companion guides, and partner‑specific validation rules.

- Document mapping/logical requirements for new partners and integration changes.

- Partner with business stakeholders for issue resolution and operational impact assessments.

- Support audit/compliance reviews and maintain data quality guardrails.

- Collaborate with EDI Analysts, DevSecOps Engineers, cloud teams, and business teams.

Education

- Bachelor’s or master’s degree in computer science, engineering, or a related technical discipline required; equivalent practical experience considered.
- Edifecs certification.

Experience

- Minimum 8 years of Edifecs product experience in EDI, healthcare, or enterprise application operations.
- Minimum 8 years EDI/HIPAA experience.
- Strong understanding of payer/provider workflows.
- Ability to interpret loops/segments/element‑level errors.
- Familiarity with Edifecs Transaction Management or equivalent tools.
- Excellent communication and stakeholder engagement skills.

Requirements

Core Technical

- Strong Proficiency in X12 / HIPAA EDI Transactions structure, rules, and field-level details of the full 270/271, 276/277, 278, 820, 834, 835, 837, 999/277CA.
- Strong understanding of EDI X12 Loop/segment/element interpretation, SNIP validations (Levels 1–7), companion guide interpretation, and error analysis at segment or element level.
- Experience with interpreting Edifecs XEngine validation resultsm, understand processing rules and transaction profiles.
- Experience working with SpecBuilder maps and implementation guides.
- Able to identify issues sourced from Edifecs routes, profiles, or rulesets.
- Able to interpret Edifecs logs and error codes (functional layer, not platform admin level).
- Proficient with identifying root causes of transaction errors, resolving mapping mismatches, troubleshooting rejections from payers or state systems, and reviewing parsed EDI structures stored in SQL databases.
- Able to understand inbound/outbound workflow architecture
- Work with integration specialists on AS2, SFTP, HTTPS flows.
- Validate data sent to/received from non-X12 partners.
- Identify issues introduced by middleware layers or APIs.
- Query SQL for transaction details.
- Validate payloads, timestamps, statuses, and error flags.
- Reconcile mismatches between raw EDI and stored data.

Process & Soft Skills

- Strong ability to communicate technical architecture decisions and trade-offs to non-technical stakeholders.
- Experience gathering and translating business reporting requirements into technical data models.
- Comfortable driving ambiguous architecture decisions to resolution with limited direction.
- Experience with agile methodologies (Scrum, Kanban) and JIRA.
- Strong documentation habits with creating transaction flow documentation, error trend reports, escalations, and updating SOPs and partner reference guides.

Nice to Have

- Knowledge of HIPAA compliance requirements in cloud data architecture
- Experience with healthcare payer/PBM systems, clearinghouses, or pharmacy operations.
- AWS certification is a bonus.

Clearance Requirement: US Citizenship required with the ability to obtain and maintain a Public Trust clearance