EDI SME

About Our Team

Our employees thrive in a culture that's fast-paced and ego-free, where innovation and collaboration are encouraged at every turn. We are an organization that provides federal agencies instant access to experienced and talented professionals who understand their unique challenges and know the most efficient ways to address them. We are continually investing in resources and talent, so we stay prepared with specialized teams in the place who are experts in creating tailored technologies. Our solutions empower Federal organizations to grow, modernize, and succeed in a rapidly evolving landscape.

We welcome diverse perspectives and seek individuals who are passionate about technology and creative problem-solving. If you enjoy learning, growing, and tackling real-world challenges, you'll thrive here. Veterans and military spouses are strongly encouraged to apply and bring their unique experience to our team.

About the Role:

Our core values of People Matter, Integrity, and a Commitment to Excellence drive all that we do. By joining us, you will become a part of a fun and diverse team of talented and creative consultants who share the goal of using the latest technology to solve business challenges. We provide our clients with a dynamic mix of services and deliver focused solutions like no one else.

We are seeking talented and bright team players who are passionate about technology and want to work in a fast-paced, dynamic, and ego-free culture while applying a creative approach to problem-solving. Team members who like to grow their skill sets while solving challenging, real world business problems thrive.

We are looking for an experienced EDI Subject Matter Expert (SME) to lead the evaluation of business requirements and translate them into actionable work items and mapping specifications for the development team. You will be responsible for designing, testing, and refining EDI solutions to ensure compliance with EDI standards. This pivotal role involves close collaboration with internal business and technical stakeholders to manage and enhance EDI transaction processes and healthcare-specific data transformations. A strong background in Edifecs is crucial for effective data mapping and transformation across cloud-based applications, contributing to the reliability and efficiency of our data exchange systems.

Key Responsibilities:

·      Collaborate with business stakeholders by participating in requirements elaboration with business subject matter experts, offering insights to ensure technical and functional feasibility.

·      Translate data and business requirements into standardized X12 formats for both inbound and outbound transactions.

·      Review and validate unit and integration test cases; coordinate with QA teams to ensure accuracy and reliability of implemented solutions.

·      Triage and troubleshooting transmission issues in collaboration with the development team.

·      Support post-implementation activities, including applying updates and patches to the Edifecs system to maintain operations and compliance with evolving standards.

·      Act as a liaison between clients and internal technical teams to ensure seamless communication and effective issue resolution.

·      Provide technical leadership and mentorship to integration developers and analysts.

·      Continuously evaluate and improve EDI processes, tools, and frameworks to support evolving business needs.

·      Work independently with minimal supervision while managing multiple priorities and deadlines.

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Required Qualifications:

·      Extensive experience as an EDI SME in a complex enterprise environment.

·      Strong knowledge of EDI standards and the healthcare domain.

·      Deep understanding of HIPAA-compliant EDI transactions, including: 837 (Claims), 834 (Enrollment), 835 (Payments), 270/271 (Eligibility), 276/277 (Claim Status), 278 (Referral/Authorization).

·      Proven experience as an EDI Business Analyst, facilitating coordination between business and development teams.

·      Familiarity with government and payer processes in healthcare.

·      Proficiency in SQL, XML, XSLT, JavaScript, and Groovy for data transformation and validation.

·      Hands-on experience with Agile project execution and contributing to continuous improvement initiatives.

·      Strong knowledge of EDI standards (X12, EDIFACT) and mapping tools.

·      Excellent analytical, problem-solving, communication, and documentation skills.

·      Bachelor’s degree and 6+ years of directly related experience, or Master’s degree and 4+ years of directly related experience. Equivalent years of experience may be accepted in lieu of a degree for certain roles. Certifications may also be accepted in lieu of a degree for specific technical positions.

Preferred Qualifications:

·      Experience with AWS-based solutions and cloud architecture.

·      Familiarity with CI/CD pipelines, Terraform, and containerized deployments using tools like Docker and Kubernetes.

·      Strong ability to prioritize and execute tasks independently and within collaborative team environments.

·      Prior experience managing custom trading partner agreements and relationships in cloud environments.

·      Previous experience working in a government or public sector setting.