Pega SSA Developer

Role: Pega SSA Developer
Location: Remote
Duration: 2 months and 1 week

Required Skills

• Pega development and application configuration
• Facets – Claims, Membership, Billing, and Provider
• EDI 835 / 837 and X12 transactions
• Healthcare claims processing and adjudication
• Pega integration with Facets and other core administration systems
• REST/SOAP APIs, connectors, and Data Pages
• Strong ability to collaborate with Business Analysts, Architects, QA, and business stakeholders

Job Description
Seeking a Pega Senior System Architect (SSA) / Developer with 8+ years of experience in Pega and strong healthcare domain knowledge, particularly claims processing and Facets integration.
The role will focus on designing, developing, and configuring Pega applications that support healthcare claims processing, adjudication, exception handling, and workflow automation.

Key Responsibilities

1. Design, develop, and configure Pega applications for healthcare claims processing, adjudication, and workflow automation integrated with Facets.
2. Work with Facets Claims, Membership, Billing, and Provider modules to support the end-to-end claims lifecycle, including intake, adjudication, and payment processing.
3. Build and customize Pega case types, flows, decision rules, and UI rules for claims exception handling and manual review processes.
4. Integrate Pega with Facets and other core administration systems using REST/SOAP APIs, connectors, and Data Pages.
5. Analyze and translate healthcare claims business requirements into Pega application designs.
6. Work with HIPAA, EDI 837/835, and X12 transactions within healthcare claims workflows.
7. Collaborate closely with Business Analysts, Architects, QA teams, and business stakeholders to understand requirements and deliver high-quality applications.
8. Troubleshoot application and integration issues and support the overall claims processing workflow.

Must-Have Experience

• 8+ years of Pega development experience
• Strong Pega application development/configuration
• Hands-on experience with Facets
• Experience with Facets Claims, Membership, Billing, and Provider
• Strong understanding of healthcare claims processing/adjudication
• Experience with EDI 835 and 837 / X12
• Pega integration using REST/SOAP APIs
• Experience translating healthcare business requirements into Pega solutions
• Strong collaboration and communication skills

Experience: 8+ years