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.