Job Overview:
We are seeking a skilled Mirth Developer with extensive experience in developing and maintaining integration solutions within pharmacy claims adjudication systems. The ideal candidate will have a strong background in healthcare IT, specifically in pharmacy claims processing, and be proficient in using Mirth Connect to streamline data exchange between healthcare systems.
Key Responsibilities:
• Integration Development:
o Design, develop, and maintain integration solutions using Mirth Connect for pharmacy claims adjudication systems.
o Develop custom channels, connectors, and transformations to facilitate data exchange between various healthcare systems, including EMR/EHR, pharmacy management, and claims adjudication platforms.
o Ensure seamless data flow and interoperability between pharmacy claims adjudication systems and other healthcare applications.
• Claims Processing:
o Work closely with pharmacy claims adjudication teams to understand business requirements and translate them into technical solutions.
o Implement and optimize integration workflows to enhance the efficiency of claims processing, ensuring accuracy and compliance with industry standards.
o Troubleshoot and resolve issues related to pharmacy claims data transmission, validation, and processing.
• Data Transformation & Mapping:
o Create and manage data transformation and mapping processes to ensure that data exchanged between systems is accurate and consistent.
o Work with HL7, XML, JSON, EDI, and other healthcare data formats to support various integration requirements.
o Ensure data integrity and compliance with HIPAA and other regulatory requirements.
• Testing & Quality Assurance:
o Conduct thorough testing of integration solutions to ensure they meet functional and performance requirements.
o Collaborate with QA teams to develop and execute test plans for integration solutions.
o Monitor and validate the performance of integrations, identifying and addressing any issues that arise.
• Documentation & Support:
o Create and maintain comprehensive documentation for integration processes, including design specifications, configuration settings, and operational procedures.
o Provide ongoing support and maintenance for deployed integration solutions, including troubleshooting and performance tuning.
Required Qualifications:
• Mirth Connect Expertise:
o Proven experience in developing and maintaining integration solutions using Mirth Connect.
o Strong knowledge of Mirth Connect’s architecture, including channels, connectors, filters, transformers, and alerts.
o Experience with deploying and managing Mirth Connect in both on-premise and cloud environments.
• Pharmacy Claims Adjudication Experience:
o In-depth understanding of pharmacy claims adjudication processes, including knowledge of NCPDP standards.
o Experience working with pharmacy claims data, including eligibility verification, prior authorization, drug utilization review, and reimbursement processes.
o Familiarity with industry regulations and standards, including HIPAA, NCPDP, and CMS guidelines.
• Healthcare Data Formats:
o Proficiency in working with healthcare data formats such as HL7, X12, EDI, XML, and JSON.
o Experience with data mapping and transformation between different healthcare data formats.
• Technical Skills:
o Strong programming skills in languages such as JavaScript, SQL, and JavaScript.
o Experience with database management systems, including SQL Server, MySQL, or PostgreSQL.
o Familiarity with web services, RESTful APIs, and other integration technologies.
• Communication & Collaboration:
o Excellent communication skills, with the ability to work effectively with both technical and non-technical stakeholders.
o Strong problem-solving skills and the ability to work independently and as part of a team.
o Experience in documenting integration solutions and providing training and support to end-users.
Preferred Qualifications:
• Experience with AWS and deploying integration solutions in cloud environments.
