Job Description
Position: Senior EDI Support Specialist with Healthcare Payer, Facets
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Location: Seattle, WA (Day 1 On-Site)
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Long Term
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Experience: 8+ Years IT | 5+ Years Healthcare Payer & EDI | 3+ Years Edifecs/TriZetto HIPAA Gateway
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Mandatory Skills
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Healthcare Payer Domain 5+ Years
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EDI Development 5+ Years
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Edifecs Suite (XEngine, SpecBuilder, TPM, Validation & Compliance) 3+ Years
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TriZetto HIPAA Gateway 3+ Years
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Facets Required
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HIPAA X12 Transactions Strong Hands-on Experience
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Trading Partner Integrations Required
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EDI Mapping & Validation Required
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SQL Server or Oracle Required
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Unix/Linux Required
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SFTP & Batch Processing Required
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API Integrations Required
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834 Enrollment Transactions
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837 Claims Transactions (P/I/D) Must Have
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835 Claims Payment Must Have
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270/271 Eligibility Must Have
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276/277 Claim Status Must Have
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278 Prior Authorization Must Have
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820 Premium Payment Must Have
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TA1 / 999 / 277CA Acknowledgements Must Have
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SQL Server or Oracle Must Have
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Unix/Linux Must Have
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SFTP & Batch Processing Must Have
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XML/XSD & JSON Must Have
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Required Skills
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Edifecs Suite, TriZetto HIPAA Gateway, BizTalk Server Facets SQL Server/Oracle Unix/Linux SFTP, Batch Processing, API Integrations XML/XSD, JSON
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Hands-on support, troubleshooting, and optimization of: 834, 837 (Professional/Institutional/Dental), 835 270/271, 276/277, 278, 820 TA1, 999, and 277CA acknowledgements
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Nice to Have
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HL7/FHIR ServiceNow MuleSoft, Boomi Groovy, JavaScript, PowerShell, Shell Scripting Blues and large-scale Facets payer environments
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Summary:
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Seeking a Senior EDI Support Specialist with strong Healthcare Payer experience to provide L2/L3 support for enterprise EDI platforms supporting Claims, Membership, Enrolment, Provider, and Payment functions.
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The role requires expertise in HIPAA X12 transaction support, production monitoring, incident resolution, trading partner management, and Edifecs/TriZetto HIPAA Gateway environments.
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Responsibilities
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- Provide L2/L3 support for EDI platforms supporting Claims, Membership, Enrolment, Billing, Provider, and Payment functions. Monitor, troubleshoot, and resolve EDI transaction failures, rejects, reconciliation, and file transmission issues.
- Support Edifecs, TriZetto HIPAA Gateway, BizTalk, and Facets-integrated environments. Perform RCA, incident resolution, and transaction performance improvements.
- Support trading partner onboarding, certification, testing, and production releases. Work with business users, vendors, and external trading partners to resolve operational issues.
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Preferred: Strong healthcare payer domain knowledge with proven experience supporting large-scale EDI operations, trading partner management, and Facets-integrated ecosystems.