Edifecs Developer

Summary

Tegria is a healthcare technology and services company focused on improving care, technology, revenue, and operations for healthcare organizations. The Edifecs Developer will design, configure, maintain, and support Edifecs applications and healthcare EDI interfaces, including HIPAA transaction processing, mapping, validation, testing, troubleshooting, and technical documentation.

Responsibilities

• Design, develop, configure, and maintain Edifecs applications and healthcare EDI interfaces
• Develop and support HIPAA transaction processing including 834, 835, 837, 270/271, 276/277, and 278 transactions
• Configure and maintain Edifecs modules such as XEngine, SpecBuilder, Transaction Management, and Smart Trading Partner Management (STPM)
• Analyze business requirements and translate them into technical solutions
• Create mapping specifications and validation rules for inbound and outbound healthcare transactions
• Troubleshoot production issues, perform root cause analysis, and resolve data integration problems
• Collaborate with business analysts, product owners, vendors, and operations teams to improve EDI workflows
• Support testing activities including unit, integration, regression, and user acceptance testing
• Ensure compliance with HIPAA regulations and healthcare industry standards
• Develop technical documentation, design documents, and support procedures

Skills

• Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or related field
• 3+ years of Edifecs development experience in a healthcare payer environment
• Strong experience with Edifecs XEngine, SpecBuilder, Translator, and STPM
• Knowledge of HIPAA EDI transactions (834, 835, 837, 270/271, 276/277, 278)
• Experience with XML, X12 EDI, SQL, Java, and Web Services
• Familiarity with healthcare claims, enrollment, provider, and eligibility processes
• Experience troubleshooting production support issues and implementing fixes
• Strong analytical, problem-solving, and communication skills
• Edifecs XEngine
• SpecBuilder
• STPM
• Transaction Management
• X12 EDI
• HIPAA Transactions
• XML/XSLT
• SQL
• Java
• REST/SOAP APIs
• Healthcare Claims Processing
• Eligibility & Enrollment Systems
• Experience working with Medicare, Medicaid, and Commercial Health Plans
• Knowledge of FHIR APIs and modern healthcare interoperability standards
• Experience with cloud platforms such as Azure or AWS
• Healthcare payer or managed care industry experience
• Edifecs certification preferred

Qualifications

Must Haves

• Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or related field
• 3+ years of Edifecs development experience in a healthcare payer environment
• Strong experience with Edifecs XEngine, SpecBuilder, Translator, and STPM
• Knowledge of HIPAA EDI transactions (834, 835, 837, 270/271, 276/277, 278)
• Experience with XML, X12 EDI, SQL, Java, and Web Services
• Familiarity with healthcare claims, enrollment, provider, and eligibility processes
• Experience troubleshooting production support issues and implementing fixes
• Strong analytical, problem-solving, and communication skills
• Edifecs XEngine
• SpecBuilder
• STPM
• Transaction Management
• X12 EDI
• HIPAA Transactions
• XML/XSLT
• SQL
• Java
• REST/SOAP APIs
• Healthcare Claims Processing
• Eligibility & Enrollment Systems

Nice to Haves

• Experience working with Medicare, Medicaid, and Commercial Health Plans
• Knowledge of FHIR APIs and modern healthcare interoperability standards
• Experience with cloud platforms such as Azure or AWS
• Healthcare payer or managed care industry experience
• Edifecs certification preferred

Benefits

• A choice of multiple health and dental plans with nationally recognized networks
• Vision benefits
• A total wellness program
• An employee assistance program for you and your family
• Retirement savings plans
• Company-paid disability and life insurance
• Pre-tax savings opportunities (HSA and/or FSA)
• Professional development offerings
• Opportunities for remote work
• A generous paid-time-off program, including time away for illness or life's important events
• Flexibility to shift your schedule to accommodate unexpected events