Senior EDI Developer – Healthcare Payer | Facets Ecosystem

Experience: 6–9 Years

Locations: Chennai | Bangalore | Hyderabad | Trivandrum

Domain: Healthcare Payer / Health Insurance

Role Overview

We are seeking an experienced Senior EDI Developer with strong expertise in Healthcare Payer systems and EDI integrations, preferably within a TriZetto Facets ecosystem.

The ideal candidate will have hands-on experience in HIPAA X12 transactions, EDI mapping, trading partner integrations, and high-volume transaction processing, along with expertise in Edifecs / TriZetto HIPAA Gateway or equivalent EDI platforms.

Key Responsibilities

- Design, develop, maintain, and optimize EDI solutions using Edifecs, TriZetto HIPAA Gateway, BizTalk, or equivalent platforms.
- Develop and maintain EDI mappings, validations, routing logic, and trading partner integrations.
- Implement and support HIPAA X12 transactions across Claims, Membership, Enrollment, Provider, and Payment domains.
- Perform EDI map optimization and support high-volume transaction processing.
- Support trading partner onboarding, testing, certification, and production deployments.
- Collaborate with Facets, business, QA, and integration teams to deliver EDI enhancements.
- Troubleshoot EDI processing issues and provide production support.
- Ensure HIPAA compliance and accuracy of EDI transactions and acknowledgements.

Required Technical Skills
- Edifecs Suite: XEngine,



SpecBuilder, Trading Partner Management, Validation & Compliance
- TriZetto HIPAA Gateway
- BizTalk Server
- TriZetto Facets
- SQL Server / Oracle
- Unix / Linux
- SFTP & Batch Processing
- API Integrations
- XML / XSD
- JSON

Required EDI Transaction Experience Hands-on experience with:
- 834 – Enrollment
- 837P / 837I / 837D – Professional / Institutional / Dental Claims
- 835 – Healthcare Payment/Remittance
- 270 / 271 – Eligibility & Benefit Inquiry/Response
- 276 / 277 – Claim Status Inquiry/Response
- 278 – Healthcare Services Review
- 820 – Payment Order/Remittance Advice
- TA1 – Interchange Acknowledgement
- 999 – Implementation Acknowledgement
- 277CA – Claim Acknowledgement

Good-to-Have Skills
- HL7 / FHIR
- MuleSoft / Boomi
- Groovy
- JavaScript
- PowerShell
- Shell Scripting
- Experience working with Blues or Blue Cross Blue Shield healthcare payer environments

Experience & Qualifications
- 6–9 years of overall IT experience.
- Solid experience in Healthcare Payer / Health Insurance domain.
- Hands-on experience in EDI development and HIPAA X12 transactions.
- Experience with Edifecs / TriZetto HIPAA Gateway and Facets ecosystem.
- Strong analytical, troubleshooting, and communication skills.
- Experience supporting enterprise-scale EDI integrations and production environments.

📌 Senior EDI Developer (Bengaluru)
🏢 Volto Consulting
📍 Bengaluru