Western Growers Health needs to design, develop, and maintain electronic data interchange (EDI) solutions to support the seamless exchange of data between its internal systems and external partners, ensuring compliance with healthcare industry standards and regulations.
Requirements
- Proven experience with EDI standards (e.g., ANSI X12) and healthcare transaction sets (837, 834, 835, etc.), highly desired.
- Hands-on experience with the PilotFish integration platform or similar ETL tools.
- Proficient in programming languages such as Java, C++, XML, and XSLT.
- Strong understanding of communication protocols used for EDI (SFTP, AS2, HTTPS).
- Experience with database technologies (SQL Server, MySQL) and data warehousing concepts.
- Solid knowledge of data mapping, transformation logic, and integration patterns.
- Familiarity with HIPAA compliance and healthcare data security standards.
Responsibilities
- Design, develop and test EDI maps, workflows and transformations for healthcare transactions (e.g., 834 enrollments, 837 claims, 835 remittances, 276/277 claim status).
- Develop, implement, and maintain EDI integration solutions to support various transaction sets.
- Create custom EDI translation maps and business rules to handle partner-specific requirements and data variations.
- Monitor scheduled EDI jobs and proactively resolve errors, ensuring SLAs with trading partners are met.
- Collaborate with internal teams (claims, finance, eligibility) to integrate data with healthcare systems.
- Build and optimize interfaces between internal systems and external trading partners.
- Write scripts, configure protocols (e.g., SFTP, AS2), and ensure secure and reliable data transmission.
Other
- Bachelor's Degree, preferably in a related field such as computer science, or information technology, along with at least 3 years of experience in EDI development or integration engineering roles, is preferred.
- Ability to work independently on technical development projects while collaborating with cross-functional teams.
- Excellent troubleshooting and problem-solving abilities.
- Strong analytical skills with attention to detail and data accuracy.
- Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet.
