Electronic Data Interchange Specialist

Job Title:

Experience:

Location:

Employment Type:

About the Role:

EDIFECS / FACETS / EDI Specialist

Key Responsibilities:

• Design, configure, and maintain

  EDIFECS

  TPF flows, maps, and rules
• Work with

  HIPAA EDI X12 transactions

  including 834 (Enrollment), 837 (Claims), 835 (Remittance), 270/271 (Eligibility), 276/277 (Claim Status)
• Troubleshoot and resolve issues using

  EDIFECS SpecBuilder, XEngine, and Route Manager

• Integrate EDI processes with the

  FACETS (TriZetto)

  platform
• Handle batch jobs, interface development, data reconciliation, and exception workflows
• Work with business teams to gather requirements and coordinate with trading partners
• Monitor file transmissions and participate in end-to-end testing

Required Skills:

• 3 to 7 years of relevant experience in healthcare EDI and integration
• Proficiency in

  EDIFECS

  tools: SpecBuilder, XEngine, TPF, Route Manager
• In-depth knowledge of

  HIPAA 4010/5010 EDI standards

  (834, 837, 835, etc.)
• Hands-on experience with

  FACETS

  modules (Enrollment, Claims, Billing, Provider)
• Intermediate

  SQL

  for data analysis and reconciliation
• Experience with file formats like

  flat files, XML, JSON, and X12

• Excellent problem-solving and communication skills

Good to Have:

• Experience with middleware/ETL tools like

  Mirth, MuleSoft, or Boomi

• Knowledge of

  Medicare/Medicaid

  processing rules
• Familiarity with

  Agile/Scrum

  methodologies
• Experience using

  FACETS API or Web Services

Why Join Us?

• Work on mission-critical healthcare systems
• Be part of a collaborative and skilled technical team
• Opportunity to work on modern integration solutions impacting real healthcare outcomes

Interested candidates can apply directly or send their resume to deepika.balijepally@eminds.ai

📢 Know someone who’s a fit? Refer or tag them below!

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