Senior EDI Developer – Healthcare Job at Beacon Hill (Philadelphia)

Senior Manager, Client Benefits

Design, plan, and manage information technology (IT) projects to deliver efficie...

Location

United States , Woonsocket

Salary:

147680.00 - 162700.00 USD / Year

CVS Health

Expiration Date

Until further notice

Requirements

Bachelor's degree (or foreign equivalent) in Computer Science, Computer Engineering, Computer Information Systems, Information Technology, Electrical Engineering, Engineering or a related field
5 years of experience in software development life cycle testing, quality assurance, and troubleshooting
5 years of experience in Waterfall and Agile Methodologies
5 years of experience in performance of Manual and Automated Testing on Windows and UNIX
5 years of experience in UI/API, Mainframe, Databases, EDI and WorkdayCloud
5 years of experience providing domain support for healthcare industry, including performing health care data analysis and testing different healthcare ERP solutions
5 years of experience in compliance and standard testing for EDI (Electronic data interchange) transactions
5 years of experience with test management tools like HP ALM, Microsoft VSTS, or JIRA
5 years of experience in Back End Testing, including developing and executing complex SQL queries
5 years of experience in Functional Testing, Integration Testing, System Testing, Regression Testing, GUI Testing and User Acceptance Testing (UAT)

Job Responsibility

Design, plan, and manage information technology (IT) projects to deliver efficient technical solutions to support CVS Health initiatives
Manage project execution for multiple software applications to ensure adherence to quality assurance standards, schedule, and scope
Serve as client point of contact in defining technology driven solutions to meet business objectives
Define project plans, strategy, and roadmap and measure progress against timelines and deliverables
Oversee and approve solutions design and develop structures and accurate benefit plan requirements to achieve intended outcomes or recommend alternatives
Serve as the subject matter expert and work with key stakeholders to determine project requirements and objectives and translate into high quality products that promote customer satisfaction
Confer with project personnel to identity and resolve problem and ensure alignment between internal teams and clients on decision making and objectives
Leverage operational metrics and production error root cause information to improve requirements gathering, configuration, and testing processes
Develop updated project plans to include new capabilities and ensure team resources are available for successful projects and initiatives
Evaluate and recommend tools, technologies, and processes to produce high quality software product platforms, and collaborate with benefits and clinical teams and customers to produce cutting-edge solutions

What we offer

CVS Health bonus, commission or short-term incentive program
Company equity award program
Full range of medical, dental, and vision benefits
401(k) retirement savings plan
Employee Stock Purchase Plan
Fully-paid term life insurance plan
Short-term and long term disability benefits
Well-being programs
Education assistance
Free development courses

Fulltime

Divisional Equality Diversity and Inclusion Partner

We are seeking an experienced EDI professional to lead and shape Equality, Diver...

Location

United Kingdom

Salary:

48000.00 - 57000.00 GBP / Year

Burman Recruitment

Expiration Date

Until further notice

Requirements

Proven experience delivering impact in an EDI-focused role
Strong understanding of EDI legislation, frameworks, and best practice
Experience developing and implementing strategic initiatives
Ability to influence and engage senior stakeholders
Excellent project management skills across multiple workstreams
Strong communication and presentation skills, including data storytelling
Ability to work independently and collaboratively in a complex environment
Experience working within the Higher Education environment

Job Responsibility

Lead the development, implementation, and evaluation of EDI strategy
Act as the subject matter expert, advising senior stakeholders
Shape inclusive culture initiatives across HR, research, education, and communications
Support governance through reporting to senior committees and boards
Build strong relationships across departments and external partners
Influence senior leaders to drive meaningful cultural change
Collaborate with HR, research teams, and external partners (including healthcare organisations)
Design and deliver EDI initiatives, training, and awareness programmes
Lead and coordinate departmental EDI action planning
Support teams in achieving EDI framework accreditations

What we offer

Flexible working and strong commitment to inclusion and wellbeing
Access to excellent professional development opportunities

Fulltime

Systems Integration Senior Specialist

The Systems Integration Specialist role requires a minimum of 3 years of experie...

Location

India , Noida

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

Minimum 3 years of experience working for Health care
Minimum 3 years of experience with Healthcare Electronic Data Interchange (EDI) mapping and EDI analysis
Minimum 3 years of experience using Edifecs Tool set, Edifecs SpecBuilder, Edifecs MapBuilder, Edifecs XEngine, Edifecs XEngine Server, Edifecs Transactions Management, Edifecs Trading Partner Management, Edifecs Application Manager (EAM), Edifecs GBD repository
Experience working in Edifecs 8.4
Minimum 3 years of experience managing, working in or developing and deploying Java or Middleware based applications
Ability to use strong industry knowledge to relate to customer needs and dissolve customer concerns
High level of focus and attention to detail
Work within the EDIFECS tools for migration
Understands HIPAA requirements inside/out
Experience working in EDIFECS migration

Job Responsibility

Involved in gathering requirements, installing, configuring and overseeing the implementation of EDIFECS
Interface with the clients business and technical resources
Design, build, and test the client’s systems
Working with an established and dynamic development team, with both clients and onsite team members

Fulltime

Senior Manager, Digital Product - RCM & Billing

We're building a world of health around every individual — shaping a more connec...

Location

United States , New York

Salary:

130295.00 - 260590.00 USD / Year

CVS Health

Expiration Date

May 31, 2026

Requirements

7+ years of experience in product development or product management within healthcare
Bachelor's degree at a minimum, Advanced degree preferred
Deep understanding of the RCM loop, including EDI 837/835 standards, ICD-10 mapping, and other billing standards
Proven track record of modernizing aging infrastructures while maintaining critical operations
Expert in optimizing APIs, SQL/Snowflake databases, and complex workflows to reduce manual touches and improve system performance
Experience tracing downstream financial leakage or insurance rejections back to specific upstream data gaps or validation failures
Working knowledge with healthcare market dynamics, value-based care, and emerging models of care delivery
Passion for innovation and building new products that make a meaningful difference in healthcare
Strong mix of analytical and creative thinking
Proficiency with product development concepts and tools (e.g., JIRA, Confluence, Figma, Lucid), agile methodologies, user journeys, and product documentation

Job Responsibility

RCM & Billing Expertise: Conduct research and consult with external experts, internal stakeholders, and clients as appropriate to establish RCM and billing best practices and guidelines for new and existing services
Strategic Prioritization & Stakeholder Diplomacy: Bring transparency to stakeholder environments by implementing visible, data-backed prioritization frameworks for billing products
Managing competing demands from diverse stakeholders
Backend Modernization & Systems Architecture: Craft a vision to shift legacy systems toward a future model that is faster, more cost effective and transparent
Modernize aging backend infrastructures while maintaining critical cash flows
Cross Functional Influence & Upstream Accountability: Work across Coding, CDI and clinical teams to drive data quality improvements at the source
Influence other upstream product teams to ensure billing requirements are prioritized in their roadmap cycles
Demonstrate ability to hold cross-functional teams accountable for shared outcomes
Financial Value Translation (ROI & Metrics): Connect KPIs (like Clean Claim Rates and Time to Bill) directly to business impact
Translate backend improvements and database migrations into compelling business cases for leadership

What we offer

Medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
eligibility for a CVS Health bonus, commission or short-term incentive program
includes an award target in the company's equity award program

Fulltime

!

Private Billing and Coding Administrator

Optegra has an exciting new job opportunity for an experienced Private Billing a...

Location

United Kingdom , Marylebone; Wetherby; Central London; Colindale

Salary:

28000.00 - 31050.00 GBP / Year

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

Intermediate use of Excel and other Microsoft products
Drive and self-motivation, the ability to get on with tasks at hand without supervision
A team player, necessary in a small to medium sized Company environment
Effective communication skills, and the ability to work well with others at all levels, including senior management
The ability to work to tight timescales and deadlines
Strong eye for accuracy and attention to detail
Positive attitude, engaging personality, with desire to learn and grow personally and professionally

Job Responsibility

Ensure private coding and billing is completed daily
Ensure that all chargeable activities undertaken are coded and invoiced
Work with hospitals to ensure enough data has been captured to enable accurate coding and invoicing
Sending proforma invoice and collect all payment before surgery
Ensuring all month end deadlines are met
Answering queries from all stakeholders
Ensuring strict checks are in place with data between hospitals
Develop strong working relationships with all internal hospital staff
Preparing the aged debt report according to the time schedule and dealing with all outstanding private invoices (selfpay and PMI)
Sending PMI invoices via EDI and clearing all the errors

What we offer

Pension
33 days annual leave inclusive of bank holidays
Private Health
Generous matched pension contributions
Flexible working and SMART working schemes
Funded training and development
Celebrating your anniversaries
Annual STAR awards
Blue Light Card (amazing discounts online and on the high street)
Free laser eye treatment for you and 20% discount for friends and family

Fulltime

Senior Analyst - Supply Chain Systems

The Senior Analyst for Supply Chain Systems is responsible for designing, implem...

Location

United States , Miramar

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

Bachelors (Required)
Two (2) years experience in a similar job
Due to the nature of systems, some activities may occur after hours and on weekends or holidays. In lieu of Education, 8 years of relevant work experience in Information Technology / System Applications / Supply Chain or in a related field

Job Responsibility

Creates, maintains and troubleshoots technical, customer and process issues, including but not limited, to Requisitioning, Approvals, PO generation, Receiving and the Matching process
Creates, maintains and troubleshoots Inventory Management processes including, but not limited to, Mobile Supply Chain
Maintains and optimizes the Item Master to include GTINs, UNSPCs, Revenue codes and other system or governmental requirements
Explores, assess, recommends and implements new functionality, technology in ERP or processes observed in the healthcare community or marketplace at large
Authors and updates SCM System policies and procedures including process workflows
Collaborates and supports all areas of supply chain for processes, efficiencies and system needs
Designs, maintains and runs SQL reports from the Production and Data Warehouse servers to answer specific requests, customer or system problems, and for monthly reporting
Designs, collaborates, tests and supports inbound and outbound interfaces with external systems, including, but not limited to, Clinical ERP, Point of use stations, GPO, Recall Management, etc
Initiates, collaborates and advises in brainstorming and road mapping sessions for Supply Chain efficiency throughout the healthcare system and serves as subject matter expert or project manager as appropriate, including developing project plans
Closes Supply Chain modules for Month End

Fulltime

Private Billing and Coding Administrator

Optegra has an exciting new job opportunity for an experienced Private Billing a...

Location

United Kingdom , Marylebone

Salary:

28000.00 - 30000.00 GBP / Year

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

Intermediate use of Excel and other Microsoft products
Drive and self-motivation, the ability to get on with tasks at hand without supervision
A team player, necessary in a small to medium sized Company environment
Effective communication skills, and the ability to work well with others at all levels, including senior management
The ability to work to tight timescales and deadlines
Strong eye for accuracy and attention to detail
Positive attitude, engaging personality, with desire to learn and grow personally and professionally

Job Responsibility

Ensure private coding and billing is completed daily
Ensure that all chargeable activities undertaken are coded and invoiced
Work with hospitals to ensure enough data has been captured to enable accurate coding and invoicing
Sending proforma invoice and collect all payment before surgery
Ensuring all month end deadlines are met
Answering queries from all stakeholders
Ensuring strict checks are in place with data between hospitals
Develop strong working relationships with all internal hospital staff
Preparing the aged debt report according to the time schedule and dealing with all outstanding private invoices (selfpay and PMI)
Sending PMI invoices via EDI and clearing all the errors

What we offer

Generous salary which is reviewed annually
Generous matched pension contributions
33 days annual leave inclusive of bank holidays
Flexible working and SMART working schemes
Funded training and development
Celebrating your anniversaries
Annual STAR awards
Blue Light Card (amazing discounts online and on the high street)
Free laser eye treatment for you and 20% discount for friends and family
Private Healthcare, 24/7 GP appointments, free Physio and counselling for your wellbeing

Fulltime

New

Data Entry Clerk

We are looking for a dependable Data Entry Clerk to support accurate recordkeepi...

Location

United States , Caldwell

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience performing data entry, including numeric entry and computer-based record updates
Strong typing skills with the ability to enter information quickly and accurately
Solid attention to detail and commitment to maintaining precise records
Basic computer proficiency, including comfort working within databases and standard office software
Ability to manage tasks independently and stay productive with minimal supervision
Prior administrative or clerical experience is preferred
Strong organizational skills and the ability to handle repetitive work with consistent accuracy

Job Responsibility

Enter numeric and text-based information into company databases and digital records with a high level of accuracy
Verify submitted information by checking for missing details, inconsistencies, and formatting errors before finalizing entries
Update existing files and maintain organized electronic records so information remains current and easy to locate
Complete assigned data processing tasks within established timelines while maintaining quality standards
Review source documents and input materials to ensure data is recorded correctly and follows company procedures
Support administrative recordkeeping activities by sorting, organizing, and managing documentation related to daily operations
Identify data issues and escalate unclear or incomplete information for correction when needed

What we offer

medical
vision
dental
life and disability insurance
company 401(k) plan

Fulltime

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Senior EDI Developer – Healthcare

Job Description

Job Responsibility

Requirements

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