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 • Cloud • Information Technology • Security • Social Impact • Software
Lead the evaluation, training, fine-tuning, deployment, and continuous improvement of AI and machine learning models. Build prompt engineering, model evaluation, benchmarking, and performance-tracking tools; optimize Elasticsearch-backed AI data systems; assess commercial and open-source LLMs; and collaborate with product, engineering, and security teams to deliver safe, scalable AI features.
Top Skills:
A/B TestingAmazon BedrockAmazon SagemakerAnthropicData PipelinesElasticsearchHugging FaceLarge Language ModelsMachine LearningMeta LlmsMistralOpenaiPrompt EngineeringPythonPyTorchScikit-LearnSupervised LearningTensorFlow
Artificial Intelligence • Cloud • Software • Infrastructure as a Service (IaaS)
Design and maintain automated testing frameworks for cloud-scale distributed systems. Build performance, load, stress, integration, API, end-to-end, chaos, security, and infrastructure tests. Integrate continuous testing into CI/CD pipelines, analyze observability data, validate Kubernetes and microservices environments, and collaborate with Engineering and SRE teams to improve reliability. The role also participates in on-call rotations and helps establish QA strategy and standards across GPU infrastructure, serverless endpoints, storage, billing, and event-driven systems.
Top Skills:
AWSAzureChaos MeshCi/CdDatadogGCPGoGrafanaGraphQLGremlinInfrastructure As Code (Iac)JmeterK6KafkaKubernetesLitmuschaosLocustOpentelemetryPrometheusPythonRabbitMQRedisTypescript
Artificial Intelligence • Cloud • Software • Infrastructure as a Service (IaaS)
Provide first-line technical and non-technical support through email, phone, chat, and video. Manage and resolve L1 tickets, troubleshoot system behavior and configurations, document solutions, explain technical issues clearly, and escalate complex problems to L2 or engineering teams. The role requires shell scripting, Python, SQL, REST APIs, GraphQL, and customer support experience, with possible weekend and allocated-shift availability.
Top Skills:
Crm/Ticketing ToolsDockerGoogle MeetGraphQLLinuxObservability ToolsPythonRest ApisShell ScriptingSQLSshTerminal CommandsZendeskZoom
What you need to know about the Austin Tech Scene
Austin has a diverse and thriving tech ecosystem thanks to home-grown companies like Dell and major campuses for IBM, AMD and Apple. The state’s flagship university, the University of Texas at Austin, is known for its engineering school, and the city is known for its annual South by Southwest tech and media conference. Austin’s tech scene spans many verticals, but it’s particularly known for hardware, including semiconductors, as well as AI, biotechnology and cloud computing. And its food and music scene, low taxes and favorable climate has made the city a destination for tech workers from across the country.
Key Facts About Austin Tech
- Number of Tech Workers: 180,500; 13.7% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Dell, IBM, AMD, Apple, Alphabet
- Key Industries: Artificial intelligence, hardware, cloud computing, software, healthtech
- Funding Landscape: $4.5 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Live Oak Ventures, Austin Ventures, Hinge Capital, Gigafund, KdT Ventures, Next Coast Ventures, Silverton Partners
- Research Centers and Universities: University of Texas, Southwestern University, Texas State University, Center for Complex Quantum Systems, Oden Institute for Computational Engineering and Sciences, Texas Advanced Computing Center
