FACETS Developer

4 weeks ago

Hyderabad, Telangana, India Enterprise Minds, Inc Full time

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

Thanks,

Renuka

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