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EDI Application Developer

Company: Partnership HealthPlan of California
Location: Fairfield
Posted on: November 26, 2022

Job Description:

To develop and maintain HIPAA compliant ANSI X12 transactions and support in EDI and other application development at PHC. Responsibilities include designing, coding, testing, and implementing each of the federal and/or state mandated transactions and other EDI applications using tools & technologies such as Sybase Ec Map, Ec Gateway, Active Batch, SQL Server and Oracle.

  • Develop HIPAA compliant ANSI X12 EDI transactions and support in EDI and other application development at PHC.
  • Develop transaction maps, processes and jobs/plans for automation using tools such as Ec Map, Ec Gateway, Active Batch, SQL Server and Oracle.
  • Provide on-going maintenance support to EDI and HIPAA transactions, processes and application development.
  • Test the EDI transactions with trading partners and other certification authorities as needed for compliance with the state and/or federal government regulations.
  • Continuous developments of HIPAA compliant ANSI X12 EDI transactions as changes and addendums are published by WPC.
  • Drive HIPAA transactions development to complete them in time as required by HIPAA deadlines.
  • Assist in identification and development process to securely transfer EDI and HIPAA compliant transactions between PHC and trading partners.
  • Participate in negotiation of trading partner agreement and implementing transactions with each trading partner.
  • Provide assistance to providers in preparing HIPAA-compliant transactions for PHC.
  • Provide training and assistance to less experienced staffs as needed.
  • Create and maintain documentation for all projects and participate in team meetings, conferences and problem solving discussions


    • Perform other assigned or needed activities required to assure success of the EDI development role and to support other work of the IT Department.

      Education and Experience
      Bachelor's degree in Computer Science, Business or a related field preferred. Comparable experience an alternative. Two years of experience in Information Systems working with EDI. Minimum two years of experience in health care EDI. Experience with large, highly complex projects desired.
      Special Skills, Licenses and Certifications
      Experience with development of EDI transactions.Knowledge of EDI translators is required. At least 2-3 years of experience with EDI Development using Translators such as Sybase Ec Map and Oracle, SQL Server 2005 and/or 2008. Experience in relational database DDL, DML, Transact SQL, PL/SQL / stored procedure is required. Experience with Microsoft technologies such as .NET and SSIS/SSRS is a plus. Knowledge of health care coding systems. Writing and verbal ability important. Writing and verbal ability important.
      Performance Based Competencies
      Ability to quickly acquire in-depth knowledge of AMYSIS software and managed care issues. Strong written and oral communication skills with ability to interpret and understand technical requirements. Excellent analytical skills to troubleshoot and resolve systems problems.
      Work Environment And Physical Demands
      More than 50% of work time is spent at a video display terminal. May be required to bend, stoop, kneel, crawl, or work in other non-standing and non-sitting positions to install cabling, systems hardware and other related equipment.
      Additional Preferred Skills:

      • At least 3-5 years of working experience in Java and MS .Net environments
      • Substantial experience working with EDI platform such as EDIFECS

        All Healthplan employees are expected to:

        • Provide a high level of service to clients;
        • Promote teamwork and cooperative effort among employees;
        • Maintain safe practices; and
        • Abide by the Healthplan's policies and procedures as they may from time to time be updated.

          The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Keywords: Partnership HealthPlan of California, Fairfield , EDI Application Developer, IT / Software / Systems , Fairfield, California

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