EDIFECS/FACETS/EDI Specialist

4 weeks ago

Hyderabad, Telangana, India Enterprise Minds, Inc Full time

#Hiring hashtag#EDIFECS hashtag#EDI hashtag#FactesDeveloper hashtag#Hyderabad

Role: EDIFECS/FACETS/EDI Specialist

Location: Hybrid/WfO

Location: Hyderabad

Required Skills:

Summary:

We are seeking a highly skilled EDIFECS/FACETS/EDI Specialist to support our healthcare integration, claims processing, and data exchange platforms.

The candidate should have strong experience working with EDI transactions, FACETS core administration platform, and EDIFECS tools for mapping, validation, and processing healthcare data.

EDI & EDIFECS

Design, configure, and maintain EDIFECS transaction processing flows (TPF), maps, and rules

Handle HIPAA EDI X12 transactions: 834 (Enrollment), 837 (Claims), 835 (Remittance), 270/271 (Eligibility), 276/277 (Claim status)

Conduct testing and validation of inbound and outbound EDI transactions

Troubleshoot and resolve issues in EDIFECS XEngine, SpecBuilder, and Route Manager

Coordinate with trading partners for connectivity setup and EDI testing

FACETS Platform

Support integration of EDI processes with FACETS core system (TriZetto)

Work with modules such as Enrollment, Claims, Billing, and Provider

Develop and maintain batch jobs, extracts, and interface points between FACETS and external systems

Perform data reconciliation and exception handling within FACETS workflows

General Integration & Support

Work closely with business teams to gather and translate integration requirements

Monitor EDI file transmissions and resolve production issues

Document workflows, mappings, and configurations

Collaborate with QA teams for end-to-end system testing

Participate in implementation and support of new trading partners or internal business units

Skill Area

Requirement

EDIFECS Tools

Strong hands-on with EDIFECS SpecBuilder, XEngine, TPF, and Route Manager

EDI Standards

In-depth knowledge of HIPAA 4010/5010 EDI formats (834, 837, 835, etc.)

FACETS

3–5 years working with FACETS core system modules and data structures

Healthcare Domain

Familiarity with payer workflows, claims lifecycle, and member/provider data

Scripting / SQL

Intermediate SQL skills for data analysis and reconciliation

File Formats

Flat files, XML, JSON, X12

Soft Skills

Strong communication, documentation, and problem-solving skills

Good to have:

Experience with ETL tools or middleware (e.g., Mirth, MuleSoft, Boomi)

Familiarity with Medicare/Medicaid processing rules

Exposure to Agile or Scrum methodologies

Prior experience with FACETS API or Web Services

Why Join Us?

Collaborative & growth-driven culture

Competitive package and benefits

If this sounds like you — or someone you know — DM me or share CV to

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