EDIFECS/FACETS/EDI Specialist

4 weeks ago

India Enterprise Minds, Inc Full time

At Enterprise Minds, we empower businesses through intelligent systems, data-driven solutions, and agile digital transformation. Headquartered in San Ramon, California, with thriving tech hubs in Hyderabad and Pune, we are a fast-growing company redefining how AI, ML, and automation drive real-world results.

Why Work with Us?

  • Innovation-First Culture: Collaborate on AI/ML, digital twins, and cloud engineering projects that make a real difference.
  • Career Growth: Work alongside industry experts and access continuous learning opportunities.
  • Global Impact: Deliver mission-critical solutions for enterprise clients worldwide.
  • People-Centric Environment: Enjoy work-life balance, mentorship, and a supportive team culture.

Job Role: EDIFECS/FACETS/EDI Specialist

Location: 100% Remote

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

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