Healthcare EDI Developer at RICEFW Technologies Inc

Role: Healthcare EDI Developer

Summary

We are expanding our Encounter Development team and seeking a Healthcare EDI Developer to support enterprise encounter reporting through timely, accurate generation and submission of 837D X12 encounter files.

Job Responsibilities

· Execute recurring operational tasks to generate encounter data files; monitor daily production jobs, troubleshoot issues, and drive error investigation through resolution.

· Design, build, and maintain X12 EDI 837 encounter processing workflows.

· Ensure solutions comply with HIPAA and X12 standards, including state- and client-specific implementation guides.

· Perform unit, integration, and regression testing for EDI processes and related data flows.

· Interpret and reconcile 999, 277, 835, and custom state/client response files associated with encounter submissions.

· Develop and maintain data mappings between internal application data models and EDI segments/loops.

· Implement corrective actions to remediate defects and reduce or eliminate repeat issues.

· Partner with external clients and internal operational teams on new client implementations and changes to existing submissions.

· Create and execute EDI test plans and provide clear, timely status updates to internal stakeholders and clients.

Experience and Qualifications

· 3+ years of relevant experience in the healthcare industry, Dental preferred

· 3+ years of experience in a data analyst role, preferably supporting healthcare EDI.

· 1+ years of experience developing post-adjudication X12 837 files (required).

· 1+ years of SQL experience.

· Working knowledge of HIPAA X12 standards, specifically the 837 claim/encounter transaction.

· Strong attention to detail with the ability to analyze client needs and accurately document processes.

· Excellent analytical, troubleshooting, and communication skills.

· Experience with IBM Sterling B2B Integrator is preferred.