EDI System Specialist

8 hours ago

Hyderabad, Telangana, India beBeeEdification Full time ₹ 21,09,000 - ₹ 24,11,000
Job Title

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

  • Main Responsibilities:
  • Create EDIFECS transaction processing flows (TPF), maps, and rules to ensure seamless system integration.
  • Handle HIPAA EDI X12 transactions: 834 (Enrollment), 837 (Claims), 835 (Remittance), 270/271 (Eligibility), 276/277 (Claim status)
  • Test and validate inbound and outbound EDI transactions to prevent errors and discrepancies.
  • Troubleshoot and resolve issues in EDIFECS XEngine, SpecBuilder, and Route Manager to minimize downtime and optimize performance.
  • FACETS Platform Expertise:
  • Support the integration of EDI processes with the FACETS core system (TriZetto) for efficient data exchange.
  • Work closely with various modules such as Enrollment, Claims, Billing, and Provider to enhance overall system functionality.
  • Develop and maintain batch jobs, extracts, and interface points between FACETS and external systems for streamlined data transfer.
  • Perform data reconciliation and exception handling within FACETS workflows to ensure accurate data processing.
  • General Integration & Support:
  • Collaborate with business teams to gather and translate integration requirements into actionable solutions.
  • Monitor EDI file transmissions and resolve production issues promptly to prevent delays.
  • Document workflows, mappings, and configurations for easy reference and knowledge sharing.
  • Partner with QA teams for end-to-end system testing to guarantee high-quality deliverables.
Benefits

This role offers a unique opportunity to work on cutting-edge technology and contribute to the development of innovative solutions that drive business growth. As an EDIFECS/FACETS/EDI specialist, you will have the chance to:

  • Expand your technical skills and expertise in EDIFECS and FACETS platforms.
  • Work collaboratively with cross-functional teams to achieve shared goals and objectives.
  • Contribute to the design and implementation of efficient data exchange solutions.
  • Pursue professional growth and development opportunities within a dynamic and supportive environment.

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