Talent.com
Senior Encounter Submissions Software Engineer / Analyst
Senior Encounter Submissions Software Engineer / AnalystInvent Health • aurangabad, India
No longer accepting applications
Senior Encounter Submissions Software Engineer / Analyst

Senior Encounter Submissions Software Engineer / Analyst

Invent Health • aurangabad, India
5 days 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 • aurangabad, India

    Related jobs
    Scientific Data Analyst

    Scientific Data Analyst

    Yonnova Scientific Consultancy • Maharashtra, India, India
    Yonnova Scientific Consultancy supports researchers in publishing smarter, faster, and better.We assist from manuscript shaping to getting published in top journals, simplifying the publication pro...Show more
    Last updated: 1 day ago • Promoted
    Analyst

    Analyst

    Innodata Inc. • Aurangabad, 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 more
    Last updated: 20 days ago • Promoted
    Senior Software Engineer

    Senior Software Engineer

    Programmers.io • aurangabad, maharashtra, 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 more
    Last updated: 30+ days ago • Promoted
    Digital Analyst

    Digital Analyst

    EXL • Aurangabad, 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 more
    Last updated: 17 days ago • Promoted
    Lead Engineer

    Lead Engineer

    Hyqoo • Aurangabad, IN
    Design, deploy, and manage AWS cloud infrastructure, including EC2 instances, S3 buckets, VPCs, RDS databases, and Lambda functions. Assist in the design, implementation, and maintenance of backup, ...Show more
    Last updated: 15 days ago • Promoted
    Senior Data Analyst

    Senior Data Analyst

    Maxillian Analytics • Aurangabad, IN
    We are seeking a talented and experienced Senior Data analyst with experience in PowerBi.As a Senior Data analyst, you have to lead data projects, aligning with strategic goals and ensuring deliver...Show more
    Last updated: 3 days ago • Promoted
    Senior Software Engineer

    Senior Software Engineer

    Prophecy Technologies • aurangabad, maharashtra, in
    We are looking for a highly skilled.The ideal candidate must have hands-on experience with.AWS, Terraform, Docker, Kubernetes / EKS. Design, provision, and manage secure, scalable cloud infrastructure...Show more
    Last updated: 7 hours ago • Promoted • New!
    Tech-Functional Business Analyst – Safety Systems (Argus, DLP, Case Processing)

    Tech-Functional Business Analyst – Safety Systems (Argus, DLP, Case Processing)

    vueverse. • aurangabad, maharashtra, in
    Senior IT / Tech-Functional Business Analyst.Pharmacovigilance (PV) safety systems, particularly.This role focuses on system configuration, enhancements, integrations, validation, and ongoing technic...Show more
    Last updated: 3 days ago • Promoted
    Software Engineer (Remote)

    Software Engineer (Remote)

    BMR Staffing • aurangabad, maharashtra, in
    Remote
    Earn Up to $5,000 / Month as a Coding Expert (Remote / Flexible).Open to professionals based in Mexico, Brazil, Colombia, Argentina, Chile, Peru, Guatemala, Honduras, Puerto Rico, and the Dominican Rep...Show more
    Last updated: 7 days ago • Promoted
    Senior DevOps & Database Reliability Engineer – 100% Remote

    Senior DevOps & Database Reliability Engineer – 100% Remote

    Hyly.AI • Aurangabad, IN
    Remote
    AI, we’re building the first AI + Data Fabric for the multifamily industry, transforming how clients manage, secure, and scale their marketing and operational data. As the industry moves toward a co...Show more
    Last updated: 12 days ago • Promoted
    Data Analyst

    Data Analyst

    Pacific Consultancy Services • Aurangabad, 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 more
    Last updated: 11 days ago • Promoted
    Senior Design Verification Engineer

    Senior Design Verification Engineer

    BITSILICA • aurangabad, maharashtra, in
    We are in search of a skilled Design Verification Engineer with at least 4 years of practical experience.As an essential member of our team, you will have a crucial role in ensuring the strength an...Show more
    Last updated: 7 hours ago • Promoted • New!
    Senior Software Engineer

    Senior Software Engineer

    Hyperhire • aurangabad, maharashtra, in
    Client : Confidential, is looking for a product-focused, well-rounded Software Engineer who loves building and shipping impactful features end-to-end. This is a highly hands-on role where you’ll wri...Show more
    Last updated: 7 hours ago • Promoted • New!
    Senior Analyst

    Senior Analyst

    Branch International • Aurangabad, 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 more
    Last updated: 20 days ago • Promoted
    Senior Security Analyst

    Senior Security Analyst

    greytHR • aurangabad, maharashtra, in
    AWS and GCP to lead cloud security initiatives, implement security tools, and secure production cloud environments.The ideal candidate should have deep knowledge of AWS security services, hands-on ...Show more
    Last updated: 7 hours ago • Promoted • New!
    Senior Quality Analyst

    Senior Quality Analyst

    Tech Exactly • aurangabad, maharashtra, in
    Review and analyze system specifications.Collaborate with QA Engineers to develop effective strategies and test plans.Execute test cases (manual) and analyze results. Evaluate product code according...Show more
    Last updated: 7 hours ago • Promoted • New!
    System Integration Specialist

    System Integration Specialist

    Alp Consulting Ltd. • Aurangabad, IN
    AI Automation & Integration Developer.AI Automation & Integration Developers.You’ll design and implement automation workflows using. APIs and enhancing business productivity with AI-driven solutions...Show more
    Last updated: 19 days ago • Promoted
    Apex Developer - Senior Analyst [T500-21577]

    Apex Developer - Senior Analyst [T500-21577]

    MUFG • aurangabad, maharashtra, 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 more
    Last updated: 7 hours ago • Promoted • New!