EDI X12 Developer
PlanStreet, Lexington, KY, United States
With the growing demand for PlanStreet’s StreetRCM platform, we are expanding our team. We are seeking a skilled Backend Developer with expertise in healthcare EDI transactions, particularly X12 837 (Claims) and X12 835 (Remittance Advice), to help drive the development and optimization of our revenue cycle management solutions.
The ideal candidate will design, develop, and maintain backend systems for processing high-volume healthcare claims and remittances using
C#, .NET, and SQL Server , ensuring compliance with HIPAA and industry standards.
Key Responsibilities
EDI & Healthcare Transactions
Design, implement, and maintain the processing of
X12 EDI 837 Professional, Institutional, and Dental claims
Implement parsing, validation, transformation, and posting of
EDI 835 remittance advice
Handle
claim lifecycle workflows , including submission, acknowledgments (999/277CA), adjudication, and payment posting
Ensure compliance with
HIPAA, X12 standards, and payer-specific implementation guides
Support error handling, rejection management, and reconciliation of claims and remittances
Develop and maintain backend services using
C#, .NET / .NET Core
Design efficient and scalable
SQL Server
schemas, stored procedures, and queries
Optimize batch processing for
high-volume EDI files
Build APIs and background services for EDI ingestion and outbound processing
Implement logging, monitoring, and audit trails for EDI transactions
Integration & Data Processing
Integrate with
clearinghouses, payers, and external healthcare systems
Process inbound/outbound files via
SFTP, APIs, or EDI gateways
Implement data mapping between EDI segments and internal application data models
Support file batching, splitting, merging, and scheduling
Quality, Security & Compliance
Perform unit, integration, and regression testing of EDI workflows
Ensure
PHI security , encryption, and access control
Support compliance audits and production issue resolution
Maintain technical documentation for EDI processes and system architecture
Required Qualifications
5+ years
of backend development experience using
C# and SQL Server
Strong hands-on experience with X12 EDI standards , specifically:
Solid understanding of
healthcare revenue cycle management (RCM)
Experience with
HIPAA compliance
and healthcare data security
Proficiency in
SQL Server performance tuning , indexing, and stored procedures
Experience processing
batch files and large datasets
Familiarity with
SFTP, EDI translators, and clearinghouse integrations
Preferred / Nice-to-Have Skills
Experience with
999, 277CA, 270/271, 276/277
transactions
Knowledge of
payer-specific EDI rules
Experience with
Azure Integration account and Logic App X12 Connector
Familiarity with
microservices architecture
Experience with
EDI validation tools or translators
Healthcare domain certifications or prior payer/clearinghouse experience
Soft Skills
Strong analytical and problem-solving skills
Ability to work independently on complex EDI workflows
Good communication skills for cross‑functional collaboration
Attention to detail, especially with healthcare compliance
#J-18808-Ljbffr
The ideal candidate will design, develop, and maintain backend systems for processing high-volume healthcare claims and remittances using
C#, .NET, and SQL Server , ensuring compliance with HIPAA and industry standards.
Key Responsibilities
EDI & Healthcare Transactions
Design, implement, and maintain the processing of
X12 EDI 837 Professional, Institutional, and Dental claims
Implement parsing, validation, transformation, and posting of
EDI 835 remittance advice
Handle
claim lifecycle workflows , including submission, acknowledgments (999/277CA), adjudication, and payment posting
Ensure compliance with
HIPAA, X12 standards, and payer-specific implementation guides
Support error handling, rejection management, and reconciliation of claims and remittances
Develop and maintain backend services using
C#, .NET / .NET Core
Design efficient and scalable
SQL Server
schemas, stored procedures, and queries
Optimize batch processing for
high-volume EDI files
Build APIs and background services for EDI ingestion and outbound processing
Implement logging, monitoring, and audit trails for EDI transactions
Integration & Data Processing
Integrate with
clearinghouses, payers, and external healthcare systems
Process inbound/outbound files via
SFTP, APIs, or EDI gateways
Implement data mapping between EDI segments and internal application data models
Support file batching, splitting, merging, and scheduling
Quality, Security & Compliance
Perform unit, integration, and regression testing of EDI workflows
Ensure
PHI security , encryption, and access control
Support compliance audits and production issue resolution
Maintain technical documentation for EDI processes and system architecture
Required Qualifications
5+ years
of backend development experience using
C# and SQL Server
Strong hands-on experience with X12 EDI standards , specifically:
Solid understanding of
healthcare revenue cycle management (RCM)
Experience with
HIPAA compliance
and healthcare data security
Proficiency in
SQL Server performance tuning , indexing, and stored procedures
Experience processing
batch files and large datasets
Familiarity with
SFTP, EDI translators, and clearinghouse integrations
Preferred / Nice-to-Have Skills
Experience with
999, 277CA, 270/271, 276/277
transactions
Knowledge of
payer-specific EDI rules
Experience with
Azure Integration account and Logic App X12 Connector
Familiarity with
microservices architecture
Experience with
EDI validation tools or translators
Healthcare domain certifications or prior payer/clearinghouse experience
Soft Skills
Strong analytical and problem-solving skills
Ability to work independently on complex EDI workflows
Good communication skills for cross‑functional collaboration
Attention to detail, especially with healthcare compliance
#J-18808-Ljbffr