Pega SSA Developer
Remote
Required Skills:
Pega
Facets (Claims, Membership,Billing,Provider)
EDI 835, 837
Good collaboration with business and other teams
Job Description:
Pega Developer with experience in Designing, developing and configuring Pega applications for Healthcare Claims processing. Skilled in building flows in Pega, integrating with application called Facets and analyzing and translating the business requirements.
Experienced in collaborating with business analysts, architects, and QA teams to deliver high quality applications.
1. Design, develop, and configure Pega applications for healthcare claims processing, adjudication, and workflow automation integrated with Facets.
2. Work on Facets modules (Claims, Membership, Billing, Provider) to support end-to-end claims lifecycle management including intake, adjudication, and payment processing.
3. Build and customize Pega case types, flows, decision rules, and UI rules to automate claims exception handling and manual review processes.
4. Integrate Pega with Facets and other core administration systems using REST/SOAP APIs, connectors, and data pages.
5. Analyze and translate healthcare claims business requirements (HIPAA, EDI 837/835, X12 transactions) into Pega application design.
Years of Experience: 10+ Years of Experience
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