[Remote] Senior Healthcare EDI Integration Engineer

Note: The job is a remote job and is open to candidates in USA. Ekfrazo Technologies Private Limited is seeking a Senior Healthcare EDI Integration Engineer with expertise in healthcare EDI and AWS infrastructure. The role involves managing EDI transactions, system administration of claims platforms, and developing automation scripts to enhance operational efficiency.ResponsibilitiesAssess, plan, and execute new business implementation and integration projects concerning EDI transactions, including but not limited to 834, 835, 837, 270/271, 276/277Manage and monitor daily processing of healthcare claims, eligibility and provider files (e.g., 834, 837, 835, 270/271, and 276/277), ensuring timely intake, validation, and staging for downstream processingFacilitate comprehensive discussions with vendors and internal stakeholders to gather, analyze, and document detailed requirements for EDI and encounter implementationsWork with customers’ technical team to create detailed technical standards-based data interface specifications ensuring customer’s technical team can effectively implement the interface to satisfy business objectives. Implement Birdsong’s interfaceUnderstand EDI mapping documents, manage communication with partners and assist in producing operational documentsEstablish and maintain relationships with external/internal partners, clients, and vendors to facilitate seamless EDI transactionsOn a monthly basis, perform member eligibility audits comparing incoming plan data (834) to system data to ensure data integrity reporting results back to leadershipAnalyze, design and develop specifications for enhancements and extensions to electronic data interchange application interfacesManage and publish new FHIR APIs as neededManage user access and permissions in alignment with security and compliance requirementsCoordinate OS updates, patches, and security hardening to servers following internal IT policiesConfigure and maintain scheduled jobs, background services, and automated tasks required for internal system operationsServe as the primary technical owner of the claims system, including file ingestion, transformation, delivery pipelines, exports, conversions, encryptions and transfersCoordinate with other IT teams (e.g., infrastructure, desktop support, security, identity management) to maintain and troubleshoot claims system infrastructure, ensuring high availability and performance of all related servers and servicesProactively monitor system health and performance; respond to alerts and incidents to ensure minimal disruption to eligibility and claims processingSupport SFTP connections and AWS lambda functions and folder structures plus S3 and Transfer FamilyTroubleshoot and resolve technical errors/incidentsAssist with ETL process to migrate business to another platformDevelop, maintain, and enhance in-house automation scripts to support claims workflows, eligibility processing, and client-specific integrationsIdentify opportunities for process automation and implement solutions to improve operational efficiency and reduce manual interventionLead technical onboarding for new clients, including AWS SFTP setup, EDI, file format validation, test file processing, and automation configurationTest new file transmissions to ensure accuracy of client implementation in lower test environments. Prepare and maintain test dataCollaborate with client IT teams to ensure secure and accurate data exchange protocols are in placeAct as the primary point of contact for external vendors (e.g., clearinghouses) to resolve file transmission, data issues or system integration issuesTroubleshoot production and lower environment issues collaborating with vendor and other technical and business staff as neededWork closely with internal stakeholders including the claims team, business operations, and finance to support audits, reporting, and issue resolutionKeep leadership abreast of critical issues with timely updates as neededSupport SOC and internal audit readiness by gathering and providing technical evidence related to claims systems, file processing, and automation workflowsEnsure compliance with HIPAA, data security standards, and internal IT policiesWork with IT leadership to develop and maintain disaster recovery (DR) procedures for claims systems and related infrastructure to ensure business continuityConduct regular DR testing in coordination with IT leadership and business stakeholders to validate recovery processes and system resilienceDocument recovery steps and ensure all critical systems and automation workflows are included in DR planningDevelop and continue to revise technical documentation representing the architecture, inbound and outbound data flows for every client, and technical details related to the systemsSkills4–7 years' of experience in IT operations or systems engineering2+ years' supporting an application platform2+ years' EDI technical support experience within healthcare payer organization or TPA2+ years' experience in AWS infrastructure. Demonstrated experience and knowledge with SFTP connections and AWS lambda functions and folder structures plus S3 and Transfer FamilyExpert in all EDI file formats: 837: Health Care Claim, 835: Health Care Claim Payment/Advice, 270/271: Eligibility Inquiry and Response, 999 and 276/277: Claims Status Inquiry and Response, 834: Benefit Enrollment and MaintenanceStrong experience writing and troubleshooting complex SQLProficiency in scripting languages (e.g., Python, PowerShell, Bash) and automation toolsExperience with file transfer protocols, and secure data exchangeFamiliarity with claims clearinghouses (e.g., Waystar) and staging processesKnowledgeable across a broad set of infrastructure platforms (commodity hardware, Windows OS, Linux OS, etc.)Understanding of different file feeds and data exchanges with business customers and/or partnersSkilled in tracking and assisting with prioritization of daily technical work in collaboration with business leadersExcellent verbal and written communication skillsDemonstrated ability to manage multiple priorities and support organizational changeExcellent analytical, research, investigation and troubleshooting skillsKnowledge/application of standard security protocols for electronic data transmissionsAbility to relate or explain technical information to non-technical staffAbility to collaborate with vendorsKnowledge of HIPAA law and ability to adhere to HIPAA standards and ability to apply standards of protected health information exchangeAbility to solve a diverse range of complex problems, working with limited directionETL experience migrating data from one system to another using AWS tools (e.g. Data Brew, Glue)Experience in developing RESTful APIs, using programming languages like Java, Python or .NETUnderstanding of the technical aspects of healthcare payer systems and/or third-party administrators is preferred1+ years' experience managing and publishing FHIR APIs. Strong understanding of FHIR standards, profiles, and best practicesExperience supporting SOC and HIPAA audits by gathering technical evidence and ensuring compliance with internal controlsCompany OverviewBusinesses move faster when their tech partner actually understands what they're building. It was founded in 2015, and is headquartered in Bengaluru, Karnataka, IND, with a workforce of 201-500 employees. Its website is https://ekfrazo.com.