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Medlogix · 1 month ago

Senior Enterprise Rules Engineer-Remote

United States

Full-time

Remote

Senior Level

5+ years exp

Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of technology and skilled staff. The Senior Enterprise Rules Engineer will design, develop, and maintain medical claims management rules, ensuring compliance with regulations while optimizing claims processing efficiency.

BillingHealth InsuranceInsuranceInsurTechMedical

Responsibilities

Review and interpret new or updated state and local legislation impacting auto insurance medical billing, translating complex regulations into clear, actionable software and data requirements

Analyze, design, and maintain sophisticated business rules within the proprietary MyMedlogix rules engines, ensuring configurations are accurate, auditable, and fully compliant with current regulations

Develop, modify, and optimize code to support evolving business logic, integrating rule changes seamlessly

Collaborate closely with Product Management, Compliance, and Engineering teams to define requirements and deliver timely compliant software updates

Deliver high-quality, fully tested, and well-documented rule releases on schedule, validating all outcomes through rigorous testing and peer reviews

Maintain comprehensive documentation of rule logic, code changes, and best practices to promote transparency and consistency across teams

Ensure the rules engine and related technology meet all information security, availability, and regulatory compliance standards

Model agile methodologies and industry-proven engineering practices to enhance efficiency, scalability, and reliability

Engage with key customers and stakeholders to anticipate market trends, identify emerging regulatory requirements, and inform future product enhancements

Perform other related duties as assigned

Qualification

MS SQL Server.NET (C#)Data driven rulesInsurance billingRegulatory complianceAgile methodologiesAnalytical skillsProblem-solving skillsCommunication skillsTeamwork

Required

Deep experience and ability to develop data driven rules and workflows

Experience with automated bulk testing of rules to quickly and efficiently validate the evolving rule sets

Expertise in MS SQL Server, including query optimization, stored procedures, and performance tuning

Proficient in .NET (C#) development, with the ability to design scalable and efficient solutions within complex rule or workflow environments

Strong understanding of insurance billing, healthcare claims, and regulatory compliance systems

Exceptional analytical and problem-solving skills, with a proven ability to translate business and regulatory needs into technical solutions, and translate technical solutions into digestible Operational flows and diagrams

Clear and effective communication skills, with the ability to collaborate across technical and business teams

Demonstrated commitment to planning, prioritization, and timely delivery in a fast-paced, agile environment

Passion for building innovative technology solutions that empower healthcare and insurance professionals

Consistently models company values and fosters a culture of teamwork, accountability, and continuous improvement

BS/MS degree in Computer Science/Engineering or equivalent

5+ years building data driven workflows and rules, or similar

5+ years of hands-on software engineering experience with MS SQL and .NET

Experience delivering solutions for insurance billing, healthcare claims, or compliance-driven systems

Familiarity with Agile-based software development processes