EZCap Automated Medical Claims Adjudicator
Budget / Salary$250–750
TypeFreelance project
LocationRemote
Posted4 weeks ago
Do not bid if you don’t have proven experience with EzCap software.
I need a developer who can turn my EzCap concept into a working engine that receives medical claims and adjudicates them end-to-end. The focus is squarely on claims processing: once an 837-P or 837-I file (or an API payload with the same data) lands in the system, the application should parse it, run every prescribed validation rule automatically, and return a clear pass/fail status for each service line.
Key Requirements:
• Practical experience with EzCap software. Please provide examples of reports or automations you've implemented specifically within this platform.
• Automated validation checks – CPT/ICD compatibility, duplicate detection, member plan match, and any other edits we load into the rule set must execute seamlessly.
• A comprehensive audit trail – every rule executed, every field touched, time-stamped for compliance reviews or audit readiness.
• Modular design – ability to easily incorporate additional edits in the future (e.g., fraud-scoring).
• Output options can include raw JSON, an 835-style file, or direct database updates—document whichever format you select.
Deliverables:
1. Source code and unit tests for the claims-processing module
2. Configurable rule library with sample medical edits loaded
3. Persistent audit-trail store with a simple viewer or export functionality
4. Deployment instructions (Docker or similar) so I can launch it easily in my environment
IMPORTANT: Share your past experiences with EzCap when submitting your proposal along with how you will manage handling large batch files.
I need a developer who can turn my EzCap concept into a working engine that receives medical claims and adjudicates them end-to-end. The focus is squarely on claims processing: once an 837-P or 837-I file (or an API payload with the same data) lands in the system, the application should parse it, run every prescribed validation rule automatically, and return a clear pass/fail status for each service line.
Key Requirements:
• Practical experience with EzCap software. Please provide examples of reports or automations you've implemented specifically within this platform.
• Automated validation checks – CPT/ICD compatibility, duplicate detection, member plan match, and any other edits we load into the rule set must execute seamlessly.
• A comprehensive audit trail – every rule executed, every field touched, time-stamped for compliance reviews or audit readiness.
• Modular design – ability to easily incorporate additional edits in the future (e.g., fraud-scoring).
• Output options can include raw JSON, an 835-style file, or direct database updates—document whichever format you select.
Deliverables:
1. Source code and unit tests for the claims-processing module
2. Configurable rule library with sample medical edits loaded
3. Persistent audit-trail store with a simple viewer or export functionality
4. Deployment instructions (Docker or similar) so I can launch it easily in my environment
IMPORTANT: Share your past experiences with EzCap when submitting your proposal along with how you will manage handling large batch files.
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