Custom Software Engineer

Project Role : Custom Software Engineer
Project Role Description : Develop custom software solutions to design, code, and enhance components across systems or applications. Use modern frameworks and agile practices to deliver scalable, high-performing solutions tailored to specific business needs.
Must have skills : Health Insurance Operations
Good to have skills : HealthEdge
Minimum 5 year(s) of experience is required
Educational Qualification : 15 years full time education

Job Summary
We are looking for a skilled HealthEdge Developer to join our healthcare insurance project. The candidate will be responsible for designing, developing, configuring, integrating, and supporting solutions using the HealthEdge HealthRules platform. The role requires a strong understanding of healthcare insurance business processes, claims, benefits, enrollment, and payer systems.
Key Responsibilities:
-Develop, configure, and customize solutions on the HealthEdge HealthRules platform.
-Work on healthcare insurance processes including claims, benefits, enrollment, membership, providers, and pricing.
-Analyze business and technical requirements and translate them into HealthEdge configurations and technical solutions.
-Configure HealthRules applications based on project-specific business requirements.
-Develop and maintain integrations between HealthEdge and external systems.
-Support claims processing, adjudication, benefit configuration, and pricing requirements.
-Perform unit testing, integration testing, defect analysis, and production support.
-Troubleshoot application and integration issues and provide root-cause analysis.
-Collaborate with Business Analysts, architects, developers, QA teams, and business stakeholders.
-Participate in requirement analysis, design discussions, code/configuration reviews, and deployment activities.
-Prepare technical documentation, configuration documents, and support documentation.
-Ensure solutions comply with healthcare industry standards, security requirements, and project guidelines.
Required Skills:
-Hands-on experience with HealthEdge HealthRules or HealthRules Payor.
-Strong understanding of US healthcare insurance/Payer domain.
-Good knowledge of Claims, Benefits, Enrollment/Membership, Provider, and Pricing processes.
-Experience with HealthEdge configuration and customization.
-Experience with healthcare application integrations and APIs.
-Strong SQL skills for data analysis and troubleshooting.
-Good understanding of SDLC, Agile methodologies, testing, and production support.
-Strong analytical, problem-solving, and communication skills.
Preferred Skills
-Experience with HealthRules Connector (HRC) or HealthRules Integration.
-Knowledge of EDI transactions, including 834, 837, 835, and 270/271.
-Experience with REST/SOAP APIs and integration technologies.
-Knowledge of healthcare standards such as HIPAA and X12.
-Experience working with US healthcare payer clients.
-Experience with cloud platforms such as Azure or AWS is an advantage.
-Experience with DevOps/CI-CD processes is a plus.
Experience
-5+ years of overall IT experience.
-3+ years of relevant HealthEdge/HealthRules experience preferred.
-Healthcare insurance/payer experience is mandatory or strongly preferred.
Education
-Bachelor''s degree in Computer Science, Information Technology, Engineering, or a related discipline.
Location
Hyderabad / Bangalore
Work model: Hybrid
Role Expectations
The candidate should be able to work independently on HealthEdge-related development/configuration activities, collaborate effectively with distributed teams, and provide production support when required. Experience working with large-scale US healthcare insurance projects will be highly preferred.


Qualification
15 years full time education