Edifecs Claims and Encounters SME

Company: Infosys
Location: Atlanta
Posted on: April 1, 2026

Job Description:

In the role of Edifecs Claims and Encounters SME with accountability for managing new states migration from legacy to Edifecs. Operating in this role the candidate is required to do solution definition, guides delivery teams, manages client interactions, and ensures regulatory compliance—while remaining hands?on in solution oversight and issue resolution for complex scenarios. Key Responsibilities Problem Definition & Functional Consulting Engage with business, IT, and compliance stakeholders to understand requirements, regulatory mandates, and operational challenges related to Claims and Encounters Analyze current?state systems, workflows, and data to identify gaps, risks, and improvement areas Convert complex business and regulatory needs into well?defined solution requirements. Solution Design & Recommendation Lead solution design and configuration approach for Edifecs Claims and Encounters implementations Evaluate multiple design and process options, assess impact and feasibility, and recommend best?fit solutions Ensure solutions conform to state Medicaid, CMS, and encounter compliance standards Architecture & Development Oversight Provide hands?on leadership for Edifecs components including: Claims and Encounter intake, validation, and reconciliation Edifecs configuration and rule frameworks Downstream integrations and reporting Work closely with development, testing, and integration teams to ensure quality, performance, and compliance Review designs, configurations, and outputs to prevent downstream compliance defects Project & Delivery Management Manage medium to large initiatives with multiple dependencies and overlapping timelines Track milestones, risks, and issues; take corrective action where required Participate in effort estimation, planning, and delivery execution, ensuring predictability and stability Client & Stakeholder Interaction Act as a key point of contact for Edifecs?related delivery with stakeholders Communicate progress, risks, and solution decisions clearly and effectively Support issue resolution by balancing client priorities, compliance needs, and delivery constraints Knowledge Sharing & Team Enablement Guide and mentor junior consultants and SMEs on Edifecs and encounter processing Contribute to project documentation, best practices, and reusable assets Support onboarding and enablement of new team members as the program scales Required Qualifications Candidate must be located within driving distance or willing to relocate to Atlanta, GA. This position may require travel to project/client location/s in USA. Bachelor’s degree or foreign equivalent required from an accredited institution. Will also consider three years of progressive experience in the specialty in lieu of every year of education. At least 7 years of Information Technology experience. Strong specialization in Edifecs Claims and Encounters Hands?on experience delivering healthcare/Medicaid encounter solutions Solid understanding of state?specific encounter and compliance requirements Proven ability to independently drive complex solution delivery Strong collaboration, communication, and problem?solving skills. Candidates authorized to work for any employer in the United States without employer-based visa sponsorship are welcome to apply. Infosys is unable to provide immigration sponsorship for this role at this time Preferred Qualifications Prior experience with healthcare or similar Medicaid payer customers Experience supporting multi?state implementations Onshore client?facing delivery experience in regulated environments The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone, email, or face to face. Extensive travel may be required as per client and project needs. Benefits Along with competitive pay, as a full-time Infosys employee you are also eligible for the following benefits: Medical/Dental/Vision/Life Insurance Long-term/Short-term Disability Health and Dependent Care Reimbursement Accounts Insurance (Accident, Critical Illness , Hospital Indemnity, Legal) 401(k) plan and contributions dependent on salary level Paid holidays plus Paid Time Off About Us Infosys is a global leader in next-generation digital services and consulting. We enable clients in more than 50 countries to navigate their digital transformation. With over four decades of experience in managing the systems and workings of global enterprises, we expertly steer our clients through their digital journey. We do it by enabling the enterprise with an AI-powered core that helps prioritize the execution of change. We also empower the business with agile digital at scale to deliver unprecedented levels of performance and customer delight. Our always-on learning agenda drives their continuous improvement through building and transferring digital skills, expertise, and ideas from our innovation ecosystem. EEO Infosys provides equal employment opportunities to applicants and employees without regard to race; color; sex; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; status as a protected veteran or spouse/family member of a protected veteran; or disability.

Keywords: Infosys, Smyrna , Edifecs Claims and Encounters SME, IT / Software / Systems , Atlanta, Georgia