EDI Developer (Healthcare / NEMT)

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