EDI X12 Healthcare Engineer

EDI X12 Healthcare Engineer
Type: Contract Consultant
Location: Remote (U.S.) - living in USA (with work permit if required)
Compensation: $150 USD / hour
About the Opportunity
We are a growing home health services organization that delivers care directly to patients' homes. We are implementing a new operational platform built on Salesforce, and we need a hands-on consultant to design and deliver our electronic claims and remittance capability from the ground up.
This is a high-impact engagement. You will be our subject matter expert for healthcare EDI, and you will have real ownership of the architecture and the tooling decisions.
What You'll Do
Design, build, and deliver end-to-end electronic billing using HIPAA X12 5010 transactions, mainly the 837P/837I (claims) and 835 (electronic remittance advice).
Evaluate whether to build, buy, or configure the EDI solution (clearinghouse integration, EDI translator, or a custom build), and recommend the best path for scale, cost, and speed.
Map billing, patient, payer, and service data from Salesforce into compliant 837 files, and process 835 files back for payment posting and reconciliation.
Set up connections with clearinghouses and payers, including trading partner enrollment, testing, and certification.
Handle acknowledgments and claim status responses (999, 277CA, TA1), plus error handling, rejections, and resubmission workflows.
Where relevant, support related transactions such as 270/271 (eligibility) and 276/277 (claim status).
Document data mappings, workflows, and support procedures, and transfer knowledge to internal teams.
Work closely with billing/revenue cycle, operations, and Salesforce stakeholders.
Required Qualifications
3+ years of hands-on experience with healthcare X12 EDI, including direct work building or supporting 837 and 835 transactions.
Strong knowledge of HIPAA 5010 implementation guides: loops, segments, and payer-specific companion guides.
Experience integrating with clearinghouses such as Availity, Waystar, Optum/Change Healthcare, or Office Ally.
Experience with an EDI translation or integration tool (for example MuleSoft, Edifecs, Boomi, IBM Sterling, Cleo, or similar), or with custom-building X12 parsers and generators.
Solid understanding of the revenue cycle, from claim creation through adjudication and payment posting.
Must be based in the United States.
Strongly Preferred
MuleSoft Anypoint Platform experience, including the X12 Connector, DataWeave, and/or Anypoint Partner Manager.
Experience pulling data from Salesforce (APIs, objects, Health Cloud a plus) and turning it into EDI transactions.
Background in home health, home infusion, DME, hospice, or other home-based care billing (Medicare, Medicaid, and commercial payers).
Experience standing up a healthcare EDI capability from scratch at an organization without one.

Work arrangement
Yes