Job Description & Details
This is a heavy-duty EDI engineering gig embedded within a healthcare payer environment centered around the TriZetto Facets ecosystem. You will be knee-deep in X12 transaction processing, wrangling high volumes of claims and enrollment data while keeping trading partner integrations stable. If you know your way around Edifecs and HIPAA gateways, this role lets you focus purely on heavy enterprise integration work without getting bogged down in front-end fluff.
What You'll Actually Be Doing
Expect to spend your days designing, building, and optimizing complex EDI mappings, custom routing logic, and end-to-end trading partner integrations. You will handle everything from onboarding new partners and running rigorous X12 compliance testing to optimizing maps for massive daily transaction volumes. A good chunk of your time goes into working alongside the Facets and core business teams to map out data flows for 834, 837, 835, and the rest of the alphabet soup of healthcare transactions, making sure payloads clear validation rules without throwing exceptions.
The Core Tech Stack
Your primary toolkit revolves around the Edifecs suite (XEngine, SpecBuilder, Trading Partner Management) and the TriZetto HIPAA Gateway, backed by BizTalk for orchestration. You need deep, practical fluency with X12 transaction sets—specifically 834 enrollment, 837 claims across professional and institutional types, 835 remittances, and eligibility files like 270/271. Solid SQL Server or Oracle database skills are non-negotiable for tracing transaction states, alongside Linux/Unix environments, SFTP batch drops, and basic API integrations.
Interview Expectations
When the hiring manager digs into your background, be prepared to walk through a specific time you troubleshot a bottleneck in high-volume EDI batch processing using Edifecs. They want to hear how you isolated the issue, optimized the map, and verified compliance without breaking downstream systems. Another key area they'll test is your understanding of Facets integration points—they want to see that you actually grasp how an 834 or 837 payload maps into core administration tables, rather than just treating EDI as isolated XML files.
Application Advice
To get past the automated screeners, your resume needs to explicitly feature exact matches for the transaction sets and platform names mentioned in the JD. Don't just say you have 'healthcare integration experience'; list out Edifecs XEngine, SpecBuilder, TriZetto HIPAA Gateway, and specific transaction codes like 834, 837I/P, and 835 front and center. Highlight any experience with Blues plans or large payers to immediately signal you understand the unique scale and compliance hurdles of this ecosystem.