Job Description

Job Description : 

We are seeking an experienced EDI Architect with extensive expertise in healthcare EDI implementations to join our team. 
The EDI Architect will be responsible for designing, implementing, and optimizing EDI solutions to streamline healthcare transactions, including claims, enrollment, eligibility, and other essential processes, while ensuring compliance with industry standards and regulations. 

Key Responsibilities: 

• EDI Solution Design: Lead the design, architecture, and implementation of healthcare EDI solutions (837, 834, 277/276, 835, 270/271, etc.) for providers, payers, and third party systems. 
• Healthcare Standards Compliance: Ensure EDI processes meet HIPAA, HITECH, ANSI X12, and other healthcare regulations and industry standards. 
• EDI Integration: Develop integration strategies to connect EDI solutions with existing healthcare applications (e.g., claims management, eligibility verification, payments). 
• End to End EDI Architecture: Architect scalable, secure EDI solutions to support high volume healthcare transactions, ensuring data accuracy, confidentiality, and integrity. 
• Data Mapping & Transformation: Define EDI message specifications, map data, and work with integration tools like IBM Sterling B2B, MuleSoft, DataPower, and other middleware platforms for message transformation. 
• EDI Workflow Optimization: Analyze existing workflows and recommend improvements to optimize EDI processes, reduce manual interventions, and enhance transaction speed and accuracy. 
• EDI Testing & Validation: Lead end to end EDI testing, ensuring compliance with healthcare standards and business requirements, and validating message exchanges. 
• EDI Monitoring & Support: Provide ongoing support for EDI transactions, monitor success, troubleshoot issues, and resolve discrepancies or errors. 
• Cross Functional Collaboration: Collaborate with business and IT teams (e.g., claims processing, enrollment) to define requirements and implement EDI solutions that align with organizational goals. 
• Documentation & Reporting: Maintain comprehensive documentation for EDI architecture, transaction specifications, and integrations. Provide regular performance updates and status reports to leadership. What We¿re Looking For: 
• Experience: 8+ years as an EDI Architect or in a similar role, specifically with healthcare EDI implementations. ¿ EDI Standards: Strong expertise in ANSI X12 and HIPAA compliant healthcare transactions (837, 834, 835, 277, 270/271, 276/277, etc.). 
• EDI Platforms & Tools: Proficiency with EDI solutions and integration platforms like IBM Sterling, MuleSoft, DataPower, Dell Boomi, or Informatica. '
• Healthcare Knowledge: Deep understanding of healthcare workflows such as claims processing, patient enrollment, eligibility verification, and payment systems. 
• EDI Mapping & Transformation: Hands on experience with data mapping, transformation, and message routing for EDI transactions. 
• System Integration: Expertise in integrating EDI systems with backend healthcare systems, CRM, claims management software, and electronic health records (EHR). 
• Compliance & Security: In depth knowledge of HIPAA, HITECH, and security standards related to data privacy, encryption, and secure data exchanges. 
• Problem Solving: Strong troubleshooting skills to resolve complex EDI issues, data inconsistencies, and implement solutions quickly. 
• Communication Skills: Excellent interpersonal and communication skills, with the ability to explain complex technical concepts to both technical and non technical stakeholders. 
• SQL Proficiency: Strong proficiency in SQL for querying databases, data analysis, and supporting integration efforts. 
•  Azure Knowledge (Preferred): Familiarity with Azure cloud services and integration with EDI solutions, including Azure Logic Apps, Azure Service Bus, and related tools. 

Technologies & Tools: 

• EDI Tools: IBM Sterling B2B, MuleSoft, DataPower, Dell Boomi, Informatica. 
• Protocols: ANSI X12, HIPAA. 
• Middleware: API Integr