Talent.com
No longer accepting applications
Senior Encounter Submissions Software Engineer / Analyst

Senior Encounter Submissions Software Engineer / Analyst

Invent Healthbharatpur, India
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 • bharatpur, India

    Related jobs
    • Promoted
    Analyst

    Analyst

    Innodata Inc.Bharatpur, 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: 17 days ago
    • Promoted
    Digital Analyst

    Digital Analyst

    EXLBharatpur, IN
    Digital Analytics Implementation Specialist.Adobe Experience Platform (AEP).The ideal candidate will be responsible for implementing and managing advanced analytics tracking frameworks, ensuring se...Show moreLast updated: 14 days ago
    • Promoted
    Saviynt IAM Analyst

    Saviynt IAM Analyst

    CoreTek LabsBharatpur, 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 day ago
    • Promoted
    • New!
    SEM Analyst

    SEM Analyst

    MavlersBharatpur, IN
    Shift Timings : 6 : 00 AM to 3 : 00 PM IST OR 7 : 30 AM to 4 : 30 PM IST.Key Technical Skills : Google Ads (All Campaign Types with PMAX, AI MAX) , Meta Ads (All Campaign Types with Meta Advantage +), TikTok...Show moreLast updated: 15 hours ago
    • Promoted
    Power Apps Lead

    Power Apps Lead

    Exult GlobalBharatpur, IN
    Location : Kochi [Hybrid] / Remote.Bachelor's degree in Computer Science, Information Technology, or a related field.Power Apps development (both canvas and model-driven apps).Proficiency in Power Pa...Show moreLast updated: 30+ days ago
    • Promoted
    Epic Cogito Data Analyst

    Epic Cogito Data Analyst

    Insight GlobalBharatpur, IN
    Cogito Data Analyst – Remote Role for U.Healthcare Projects (Based in India).Contract | 12-Month Assignment | Pacific Standard Hours. Take your analytics career global! This is an opportunity to wor...Show moreLast updated: 10 days ago
    • Promoted
    Senior Analyst - Oceania KYC [T500-19972]

    Senior Analyst - Oceania KYC [T500-19972]

    MUFGBharatpur, IN
    Japan’s premier bank, with a global network spanning in more than 40 markets.Outside of Japan, the bank offers an extensive scope of commercial and investment banking products and services to busin...Show moreLast updated: 1 day ago
    • Promoted
    Senior Security Analyst (Offensive)

    Senior Security Analyst (Offensive)

    CloudSEKBharatpur, 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 day ago
    • Promoted
    Senior Analyst - Performance Attribution, Malaysia

    Senior Analyst - Performance Attribution, Malaysia

    Invartis ConsultingBharatpur, IN
    Job Location - Cyberjaya Malaysia.This role will require relocation to Malaysia.The position is not based in India.We are seeking to hire well experienced Techno-functional Investment Performance O...Show moreLast updated: 30+ days ago
    • Promoted
    Global Analyst

    Global Analyst

    Alp Consulting Ltd.Bharatpur, IN
    Strong analytical skills, with experience in structuring and interpreting complex data sets.Excellent written and verbal communication skills, with the ability to present findings clearly to divers...Show moreLast updated: 2 days ago
    • Promoted
    Senior Analyst

    Senior Analyst

    Branch InternationalBharatpur, IN
    Branch is a leading AI-based lending fintech with 50M+ downloads across India and Africa.We use alternative data to reach millions of people that are largely excluded from the financial sector.Head...Show moreLast updated: 17 days ago
    • Promoted
    Software Associate

    Software Associate

    ConfidentialBharatpur, IN
    Are you passionate about clean, production-level code and mentoring aspiring engineers? Join us as a.Code Quality Analyst / Software Associate. This fully remote position offers the opportunity to mak...Show moreLast updated: 15 days ago
    • Promoted
    Geospatial Analyst - 51201

    Geospatial Analyst - 51201

    TuringBharatpur, IN
    We’re looking for Geospatial Experts to help advance AI systems through Supervised Fine-Tuning (SFT), Reinforcement Learning with Human Feedback (RLHF), and Evaluation (Evals).In this role, you’ll ...Show moreLast updated: 10 days ago
    • Promoted
    Sr. Product Data Analyst

    Sr. Product Data Analyst

    Blackhawk NetworkBharatpur, IN
    We are looking for a Senior Product Data Analyst to join our Online Commerce Product Line.This role will be critical in driving analytics strategy, enabling insight generation, and partnering with ...Show moreLast updated: 1 day ago
    • Promoted
    Implementation Engineer(Data Analyst,Data aggregation, Data Visualisation exp) with New Zealand Product based Co in Pune

    Implementation Engineer(Data Analyst,Data aggregation, Data Visualisation exp) with New Zealand Product based Co in Pune

    Seventh Contact Hiring SolutionsBharatpur, IN
    Degree or equivalent level of experience.Bachelor’s degree in computer science engineering or a related field.From good college & good academic score. Please try to share candidates from Aviation in...Show moreLast updated: 1 day ago
    • Promoted
    Senior Encounter Submissions Software Engineer / Analyst

    Senior Encounter Submissions Software Engineer / Analyst

    Invent HealthBharatpur, IN
    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 processi...Show moreLast updated: 2 days ago
    • Promoted
    Data Analyst

    Data Analyst

    Pacific Consultancy ServicesBharatpur, IN
    Pacific Consultancy Services LLC is a leading provider of innovative and cost-effective information technology (IT) solutions and services specializing in IT staffing and consulting.We serve client...Show moreLast updated: 8 days ago
    • Promoted
    Sr. Analyst or Associate

    Sr. Analyst or Associate

    Tequity AdvisorsBharatpur, 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: 2 days ago