The EDI Developer will be responsible for designing, building, maintaining, and supporting healthcare EDI integrations across multiple transaction types. This role requires strong .NET expertise, hands-on experience with EdiFabric, and a deep understanding of healthcare claims workflows, payer companion guides, and real-world EDI behavior.
Experience with Non-Emergency Medical Transportation (NEMT) is a significant advantage, as many integrations involve transportation-specific billing logic, modifiers, and state Medicaid requirements.
KEY RESPONSIBILITIES
Design, implement, and maintain healthcare EDI pipelines using .NET and EdiFabric
Parse, validate, generate, and troubleshoot EDI transactions, including:
834 – Eligibility / Enrollment
837 (P / I / D) – Healthcare Claims
835 – Remittance Advice
270/271, 999, 277CA
Interpret and implement payer-specific companion guides
Manage end-to-end claims workflows:
Intake, validation, and submission
Acknowledgments (999, 277CA)
Remittance processing and posting (835)
Error handling, corrections, and resubmissions
Build and maintain robust logging, auditing, and reconciliation processes
Collaborate with product, operations, and external partners (health plans and transportation providers)
Ensure HIPAA-compliant data handling and monitoring
Contribute to and operate within a microservices-based architecture
REQUIRED QUALIFICATIONS
5+ years of healthcare EDI development experience
Strong proficiency in C# / .NET
Hands-on production experience with EdiFabric
Deep understanding of healthcare EDI standards and workflows:
X12 structure, loops, segments, and qualifiers
Claims lifecycle and remittance processing
Proven experience implementing payer companion guides
Strong troubleshooting skills for real-world EDI issues (payer rejections, inconsistencies, edge cases)
Solid understanding of HIPAA and secure data handling practices
STRONGLY PREFERRED / NICE TO HAVE
NEMT industry experience (major plus)
Experience with Medicaid and managed care plans
Hands-on experience with:
Docker
Docker Compose
Kubernetes
Familiarity with:
GitHub
GitHub Actions (CI/CD pipelines)
Exposure to microservices architectures
Familiarity with Protobuf / gRPC
Experience deploying and operating backend services in cloud environments
WHAT WE’RE LOOKING FOR
We are not looking for a generic backend developer with light EDI exposure. This role requires someone who:
Understands how healthcare claims actually flow end-to-end
Can read and implement companion guides without hand-holding
Has dealt with inconsistent payer behavior in production
Is comfortable owning EDI workflows from ingestion through reconciliation
WHY MEDIDRIVE
Work on real, high-volume healthcare and Medicaid integrations
Senior-level ownership and autonomy
Modern, containerized architecture
Remote-friendly environment
Opportunity to shape the EDI foundation of a growing NEMT platform