Job#: 3037627

Job Description:

Location: Fully Remote, EST or Central hours.

Pay rate- 60-70/hr. Depending on years of experience.

We are seeking a professional with strong communication skills and deep experience in healthcare EDI, claims platform administration, scripting, automation, AWS infrastructure, and SQL. This role involves migrating to a new claims system, deploying it into AWS, and supporting production environments. The ideal candidate is self-sufficient, an excellent communicator, and capable of collaborating with internal teams, external customers, stakeholders, and vendors.

• Assess, plan, and execute new business implementation and integration projects for EDI transactions (834, 835, 837, 270/271, 276/277).
• Manage and monitor the daily processing of healthcare claims, eligibility, and provider files, ensuring timely intake and validation.
• Serve as the primary technical owner of the claims system, including file ingestion, transformation, delivery pipelines, and transfers.
• Develop, maintain, and enhance in-house automation scripts to support claims workflows and eligibility processing.
• Lead technical onboarding for new clients, including AWS SFTP setup, EDI validation, and test file processing.
• Act as the primary point of contact for external vendors to resolve file transmission, data, or system integration issues.
• Support audit readiness by providing technical evidence related to claims systems, file processing, and automation workflows.
• Develop and maintain technical documentation for architecture, data flows, and system details.

• 4–7 years of experience in IT operations or systems engineering.
• 2+ years of recent experience in healthcare EDI, with the ability to read, configure, implement, and test file structures (834, 835, 837).
• 2+ years of experience in AWS infrastructure, including hands-on work with Lambda, SFTP, S3, and Transfer Family.
• 2+ years of experience supporting an application platform, including administration, troubleshooting, monitoring, and access management.
• Strong experience writing and running advanced SQL queries, particularly with MS SQL.
• Proficiency in scripting languages (e.g., Python, PowerShell, Bash) for automation.
• Excellent communication skills for collaborating with technical and non-technical staff, customers, and vendors.

• ETL experience using AWS tools such as Data Brew or Glue.
• Python scripting experience.
• Experience developing RESTful APIs.
• Familiarity with claims clearinghouses (e.g., Waystar).
• Experience managing and publishing FHIR APIs.
• A Bachelor's degree in a relevant technology field is preferred.

Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico.

Everforth Apex uses a virtual recruiter as part of the application process. Click here for more details. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Everforth Apex and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at https://www.apexsystems.com/privacy-policy

Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide.

Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

If you require an accommodation under the Americans with Disabilities Act to participate in an interview with a virtual recruiter or to use our website for a search or application, please contact our Benefits Department at [email protected] or 804-523-8228. Please note that this contact information is strictly to be used for medical ADA accommodations and that no other inquiries will be answered.

UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems.