[Hiring] Pega Healthcare Claims Developer @Iconma Portal

Role Description

Our client, an IT Services and Consulting company, is looking for a Pega Healthcare Claims Developer – Facets / EDI 835/837 for their Remote location.

• Pega Developer with experience in designing, developing, and configuring Pega applications for healthcare claims processing.
• Skilled in building flows in Pega, integrating with an application called Facets, and analyzing and translating business requirements.
• Design, develop, and configure Pega applications for healthcare claims processing, adjudication, and workflow automation integrated with Facets.
• Work on Facets modules (Claims, Membership, Billing, Provider) to support end-to-end claims lifecycle management including intake, adjudication, and payment processing.
• Build and customize Pega case types, flows, decision rules, and UI rules to automate claims exception handling and manual review processes.
• Integrate Pega with Facets and other core administration systems using REST/SOAP APIs, connectors, and data pages.
• Analyze and translate healthcare claims business requirements (HIPAA, EDI 837/835, X12 transactions) into Pega application design.

Qualifications

• Good collaboration with business and other teams.
• Experienced in collaborating with business analysts, architects, and QA teams to deliver high-quality applications.
• Years of Experience: 8+ Years of Experience.

Requirements

• Pega
• Facets (Claims, Membership, Billing, Provider)
• EDI 835, 837

Benefits

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities