EDI Staffing, an EDI Specialists Company ยท 2 months ago
Remote Senior Rules Developer
United States
Full-time
Remote
Senior Level
5+ years expEDI Staffing is an EDI Specialists Company focused on medical claims management solutions. They are seeking a Remote Senior Rules Developer to design, develop, and maintain complex rules that ensure compliance with insurance regulations and optimize claims processing efficiency.
ConsultingHuman ResourcesInformation TechnologyStaffing Agency
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 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
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
Preferred
Familiarity with AI tools and technology
Experience with SaaS platform architecture and web application design
Prior experience working with rules engines, business rules management systems (BRMS), or similar frameworks
Company
EDI Staffing, an EDI Specialists Company
EDI Staffing is a staffing and recruiting company that provides consultancy and placement services.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Joseph Gilbody
President/CEO
Manuel DaRosa. CPA
CFO
Company data provided by crunchbase