Talent.com
Senior Encounter Submissions Software Engineer / Analyst

Senior Encounter Submissions Software Engineer / Analyst

Invent Healthpanchkula, haryana, in
1 day ago
Job description

Invent Health Inc. — Silicon Valley, CA (Remote / Hybrid)

Full-Time | Encounter Data | Medicaid, MA, ACA | Databricks | EMR / EDI Integrations

Invent Health is a fast-growing AI-driven healthcare analytics company processing  5.5M+ member lives  across Medicare Advantage, Medicaid (MCP / Medi-Cal), and ACA plans. Known for industry-leading NLP accuracy (85–90%), encounter reconciliation, and enterprise-grade interoperability, we are now expanding into a  next-generation Encounter Submissions System  — fully integrated with our Modular Analytics Platform (MAP) and Databricks-powered data ecosystem.

We are looking for a  Senior Encounter Submissions Software Engineer / Analyst  who will  design, architect, and build the new IH Encounter Submissions engine , including validation, reconciliation, error correction workflows, and payer-ready outbound formats across MA, Medicaid, and ACA.

What You Will Build (Core Responsibilities) 1. Architect Invent Health’s new Encounter Submissions System

  • Design the end-to-end encounter pipeline supporting MA, Medicaid, and ACA encounter standards.
  • Map and manage records across  837 ,  277 / 278 ,  999 ,  TA1 ,  MAO-002 ,  MAO-004 ,  MMR / MOR , and Medicaid T-MSIS / T-XIX formats.
  • Build automated validation rules (CMS, State, DNSP, plan-specific edits).
  • Implement logic for sequencing, batching, routing, acknowledgements, and error tracking.

2. Build a scalable, cloud-native ETL & validation pipeline

  • Design Databricks or Spark-based transformations for inbound / outbound encounters.
  • Build crosswalks between claims, encounters, provider data, member data, and IH’s internal linked records.
  • Own schema evolution, versioning, and pipeline observability.
  • 3. Create Error Correction & Workflow Tools

  • Define and implement the rules for :
  • FQHC / RHC logic
  • Allowed modifier combinations
  • Missing / invalid diagnosis or procedure codes
  • Duplicate detection
  • Non-payment encounters
  • Build dashboards for QA teams and plan analysts to triage and fix errors.
  • 4. Integrate with Invent Health modules

  • Build consistent linking with MAP : risk adjustment, coding, quality, ACA XML, CDU, IHA, and NLP workbench.
  • Expose encounter health metrics into RAF, Risk Analytics, and provider dashboards.
  • 5. Compliance, Testing & Deployment

  • Ensure all formats adhere to CMS / state regulations.
  • Implement automated regression testing across multiple plan templates.
  • Work with client engineering teams to support plan onboarding.
  • Required Experience

    You should have  5–10+ years  of hands-on experience in the following :

    Encounter Data Expertise

  • Deep knowledge of  Medicare Advantage Encounter Data  (MAOs), especially :
  • MAO-002 (Submission Status)
  • MAO-004 (Risk Score / Diagnosis Deletion)
  • MMR / MOR
  • Strong understanding of  Medicaid encounters , including T-MSIS and state-specific rules.
  • Prior experience building or maintaining  Encounter Submission engines  or EDI systems.
  • Technical Skills

  • Strong SQL + Python; Spark / Databricks experience preferred.
  • Familiarity with AWS, Delta Lake, ETL orchestration.
  • EDI parsing (837P / I / D), X12 standards, schema validators.
  • Experience with multi-source clinical / claims data.
  • Nice-to-Have

  • Experience working with health plans, TPAs, or vendors like Cotiviti, Edifecs, Change Healthcare, etc.
  • Knowledge of provider data, coding workflows, NLP-based coding, risk adjustment operations.
  • What Makes This Role Special

    This is not a maintenance role — this is a  build-from-scratch, greenfield system  that becomes a  core Invent Health product module  used by top Medicaid and MAO clients.

    You will :

  • Lead architecture & design decisions.
  • Influence product roadmap.
  • Work directly with Invent Health’s CEO, engineering, and analytics leaders.
  • Own a system that will scale across millions of encounters each month.
  • Benefits

  • Competitive salary + equity
  • Hybrid / remote flexibility
  • Direct impact on a new enterprise product
  • Work in a high-growth, award-winning AI healthtech company (TiE50, AWS Bedrock partner)
  • Create a job alert for this search

    Senior Software Engineer • panchkula, haryana, in

    Related jobs
    • Promoted
    Senior Software Engineer

    Senior Software Engineer

    Talentnautspanchkula, haryana, in
    We are a new-age AI-First Digital and Cloud Engineering services company that drives Agility and Relevance for our client’s success. Powered by cutting-edge technology solutions that enable new busi...Show moreLast updated: 26 days ago
    • Promoted
    Senior Software Engineer

    Senior Software Engineer

    BrightEdgebaddi, himachal pradesh, in
    Staff / Senior Software Engineer, Remote.The Software Engineer will be a critical individual contributor responsible for designing collection strategies, developing, and maintaining robust and scala...Show moreLast updated: 30+ days ago
    • Promoted
    Business Systems Analyst

    Business Systems Analyst

    AVASO Technology SolutionsMohali district, India, India
    AVASO Technology Solutions is currently seeking a.IT Services to big national as well as international clients across multiple industries. We are an IT solution provider with coverage in more than 1...Show moreLast updated: 16 days ago
    • Promoted
    Assistant Professor

    Assistant Professor

    Shoolini UniversitySolan, Himachal Pradesh, India
    Job Title : Assistant Professor – Computer Science.Shoolini University Centre for Distance & Online Education (SCDOE).Full-time (Campus presence as required). The Assistant Professor will support tea...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Senior Software Engineer

    Senior Software Engineer

    Digilepanchkula, haryana, in
    Develop and configure ServiceNow modules, especially.Build custom applications, UI Policies, UI Actions, Business Rules, Script Includes, Client Scripts, and Workflows. Develop and maintain Service ...Show moreLast updated: 1 hour ago
    • Promoted
    Analyst

    Analyst

    Innodata Inc.panchkula, haryana, in
    Innodata is collaborating with a leading international conglomerate, to contract subject matter experts (SMEs) for a complex prompt data annotation project. SMEs will create complex prompts and resp...Show moreLast updated: 15 days ago
    • Promoted
    Sr. Data Entry / Analyst

    Sr. Data Entry / Analyst

    Faspin Technologies Pvt. Ltd.Mohali district, India, India
    Data Entry / Analyst at Faspin Technologies Pvt.Are you a highly analytical and experienced Senior Data Entry / Analyst with a passion for transforming complex data into actionable insights? Faspin T...Show moreLast updated: 30+ days ago
    • Promoted
    Assistant / Associate Professor

    Assistant / Associate Professor

    Chitkara UniversityRajpura, Punjab, India
    Chitkara University is Looking for Associate / Assistant Professor in Chitkara School of Planning and Architecture.Conduct of subject classes in a domain or general subjects, over the hour's module.S...Show moreLast updated: 3 days ago
    • Promoted
    Senior Software Engineer

    Senior Software Engineer

    Arrowbaddi, himachal pradesh, in
    Arrow is focused on revolutionizing healthcare payments by bringing speed, accuracy, and transparency to the process.Our mission is to simplify healthcare payments for patients, providers, and heal...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Resident Engineer-Storage Solutions

    Resident Engineer-Storage Solutions

    Millennium Technology Servicespanchkula, haryana, in
    The Storage Resident Engineer serves as the onsite technical expert responsible for the deployment, administration, optimization, and ongoing support of Storage Solutions.This role ensures the cust...Show moreLast updated: 1 hour ago
    • Promoted
    Senior Software Engineer

    Senior Software Engineer

    Programmers.iobaddi, himachal pradesh, in
    We are seeking a highly skilled and experienced Senior Azure Data Engineer to join our team.The ideal candidate will have deep expertise in Microsoft Azure data services, cloud-based data engineeri...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Senior Software Tester

    Senior Software Tester

    Wall Street Consulting Services LLCbaddi, himachal pradesh, in
    Location : Onsite in Rayadurgam, Hyderabad.Experience Level : 7 - 12 Years.We are seeking a highly skilled Senior QA Analyst with strong expertise in Power BI Testing, Azure Data Factory (ADF), ETL / E...Show moreLast updated: 1 hour ago
    • Promoted
    • New!
    Senior Software Engineer

    Senior Software Engineer

    Generative Futuresbaddi, himachal pradesh, in
    Remote Senior Back-End Engineer.We’re looking for a skilled Back-End Engineer to join a leading trading firm! In this role, you’ll develop and maintain robust back-end systems that power the tradin...Show moreLast updated: 1 hour ago
    • Promoted
    Senior Analyst

    Senior Analyst

    Eclerx Services Limited, Mumbai, MaharashtraMohali district, India, India
    The Real Time Analyst is responsible for managing and ensuring that the service level agreements for various programs are met. Manage the call\Chat volume, daily attendance and program break schedul...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Senior Security Analyst (Offensive)

    Senior Security Analyst (Offensive)

    CloudSEKbaddi, himachal pradesh, in
    We are a bunch of super enthusiastic, passionate, and highly driven people, working to achieve a common goal! We believe that work and the workplace should be joyful and always buzzing with energy!...Show moreLast updated: 1 hour ago
    • Promoted
    Full Stack Trainer

    Full Stack Trainer

    Chitkara UniversityRajpura, Punjab, India
    We are seeking an experienced and passionate React / React.Development Trainers to join our team on a Full-time basis.As a trainer, you will be responsible for delivering engaging and informative tra...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Saviynt IAM Analyst

    Saviynt IAM Analyst

    CoreTek Labspanchkula, haryana, in
    You will contribute to enterprise-wide Identity and Access Management (IAM) initiatives, help shape security operations strategy, and support compliance and governance efforts.Design and deploy adv...Show moreLast updated: 1 hour ago
    • Promoted
    • New!
    Sr. Analyst or Associate

    Sr. Analyst or Associate

    Tequity Advisorspanchkula, haryana, in
    Tequity Advisors is dedicated to achieving the best outcomes for our clients through successful M&A transactions within Cloud, SaaS, and IT ecosystems. Leveraging our deep industry knowledge and glo...Show moreLast updated: 18 hours ago