Owns and troubleshoots healthcare EDI workflows using Edifecs, including X12 transaction validation, mapping, partner requirements, error analysis, SQL reconciliation, and payer or state-system issue resolution. Documents integration requirements, supports audits and data quality controls, collaborates with technical and business stakeholders, and helps resolve architecture and operational issues. Requires extensive Edifecs, EDI, and HIPAA experience, plus eligibility for a Public Trust clearance.
The SW Engineer Principal (Edifecs EDI Analyst Transaction Specialist) owns functional EDI workflows, partner requirements, and data validation rules. This role ensures accurate transaction processing and supports business operations. This is a 100% Remote role.
Job Description
- Interpret and troubleshoot transaction sets: 270/271, 276/277, 278, 820, 834, 835, 837, 999/277CA.
- Analyze SNIP compliance, companion guides, and partner‑specific validation rules.
- Document mapping/logical requirements for new partners and integration changes.
- Partner with business stakeholders for issue resolution and operational impact assessments.
- Support audit/compliance reviews and maintain data quality guardrails.
- Collaborate with EDI Analysts, DevSecOps Engineers, cloud teams, and business teams.
Education
- Bachelor’s or master’s degree in computer science, engineering, or a related technical discipline required; equivalent practical experience considered.
- Edifecs certification.
Experience
- Minimum 8 years of Edifecs product experience in EDI, healthcare, or enterprise application operations.
- Minimum 8 years EDI/HIPAA experience.
- Strong understanding of payer/provider workflows.
- Ability to interpret loops/segments/element‑level errors.
- Familiarity with Edifecs Transaction Management or equivalent tools.
- Excellent communication and stakeholder engagement skills.
Requirements
Core Technical
- Strong Proficiency in X12 / HIPAA EDI Transactions structure, rules, and field-level details of the full 270/271, 276/277, 278, 820, 834, 835, 837, 999/277CA.
- Strong understanding of EDI X12 Loop/segment/element interpretation, SNIP validations (Levels 1–7), companion guide interpretation, and error analysis at segment or element level.
- Experience with interpreting Edifecs XEngine validation resultsm, understand processing rules and transaction profiles.
- Experience working with SpecBuilder maps and implementation guides.
- Able to identify issues sourced from Edifecs routes, profiles, or rulesets.
- Able to interpret Edifecs logs and error codes (functional layer, not platform admin level).
- Proficient with identifying root causes of transaction errors, resolving mapping mismatches, troubleshooting rejections from payers or state systems, and reviewing parsed EDI structures stored in SQL databases.
- Able to understand inbound/outbound workflow architecture
- Work with integration specialists on AS2, SFTP, HTTPS flows.
- Validate data sent to/received from non-X12 partners.
- Identify issues introduced by middleware layers or APIs.
- Query SQL for transaction details.
- Validate payloads, timestamps, statuses, and error flags.
- Reconcile mismatches between raw EDI and stored data.
Process & Soft Skills
- Strong ability to communicate technical architecture decisions and trade-offs to non-technical stakeholders.
- Experience gathering and translating business reporting requirements into technical data models.
- Comfortable driving ambiguous architecture decisions to resolution with limited direction.
- Experience with agile methodologies (Scrum, Kanban) and JIRA.
- Strong documentation habits with creating transaction flow documentation, error trend reports, escalations, and updating SOPs and partner reference guides.
Nice to Have
- Knowledge of HIPAA compliance requirements in cloud data architecture
- Experience with healthcare payer/PBM systems, clearinghouses, or pharmacy operations.
- AWS certification is a bonus.
Clearance Requirement: US Citizenship required with the ability to obtain and maintain a Public Trust clearance.
About UsSAIC® is a premier mission integrator focused on advancing the power of technology and innovation to serve and protect our world. Our robust portfolio of offerings across the defense, space, intelligence, and civilian markets includes secure high-end solutions in mission IT, enterprise IT, engineering services, and professional services. We integrate emerging technology, rapidly and securely, into mission critical operations that modernize and enable critical national imperatives.We are approximately 23,000 strong; driven by mission, united by purpose, and inspired by opportunities. SAIC is an Equal Opportunity Employer. Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $7.3 billion. For more information, visit saic.com. For ongoing news, please visit our newsroom.
Similar Jobs
Artificial Intelligence • Fintech • Software • Travel
Own end-to-end account-based marketing programs for Engine’s Omni and OBT products. Responsibilities include account targeting, personalization, creative asset production, paid campaigns, gifting and direct mail, account research, pipeline reporting, and sales partnership. The role requires building scalable ABM playbooks, influencing strategic enterprise opportunities, analyzing campaign performance, and improving adoption among partner acquisition teams.
Top Skills:
LinkedInMatched AudiencesRetargetingSales NavigatorSendosoSQLZoominfo
Fintech • Financial Services
Own consumer lending credit risk analysis across underwriting, originations, loan performance, loss mitigation, collections, and recovery. Develop recommendations for credit policy, analyze delinquency and loss drivers, design testing strategies, contribute to risk model development and monitoring, and improve application funnels. The role requires strong SQL and Python skills, quantitative analysis, autonomous problem-solving, and clear communication with executives, product, engineering, finance, and lending partners.
Top Skills:
AIGradient BoostingLogistic RegressionPythonSQL
Healthtech
Supports radiology providers through inbound and outbound calls, answers workflow and platform questions, troubleshoots issues, documents interactions accurately, and escalates system or workflow concerns. The role collaborates with internal teams, participates in training and quality reviews, and delivers timely, professional, service-focused provider support.
Top Skills:
Phone Tracking System
What you need to know about the Boston Tech Scene
Boston is a powerhouse for technology innovation thanks to world-class research universities like MIT and Harvard and a robust pipeline of venture capital investment. Host to the first telephone call and one of the first general-purpose computers ever put into use, Boston is now a hub for biotechnology, robotics and artificial intelligence — though it’s also home to several B2B software giants. So it’s no surprise that the city consistently ranks among the greatest startup ecosystems in the world.
Key Facts About Boston Tech
- Number of Tech Workers: 269,000; 9.4% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Thermo Fisher Scientific, Toast, Klaviyo, HubSpot, DraftKings
- Key Industries: Artificial intelligence, biotechnology, robotics, software, aerospace
- Funding Landscape: $15.7 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Summit Partners, Volition Capital, Bain Capital Ventures, MassVentures, Highland Capital Partners
- Research Centers and Universities: MIT, Harvard University, Boston College, Tufts University, Boston University, Northeastern University, Smithsonian Astrophysical Observatory, National Bureau of Economic Research, Broad Institute, Lowell Center for Space Science & Technology, National Emerging Infectious Diseases Laboratories
