Medical Billing Backend Developer

We are seeking a skilled developer to integrate our medical billing system with a clearinghouse using HIPAA standards. NCCI, Migrate Billing System to Self-Hosted Backend, The role involves working on the backend to ensure accurate and secure processing of medical claims. Experience with medical billing systems and HIPAA compliance is essential. This is a part-time, intermediate or expert-level position for a 1-3 month engagement. Now the porotype system already build on Base44, We need migrate the system to a new HIPAA compliant database. Category / specialty Web Development → Back-End Development (also tag: Healthcare IT, EDI, HIPAA) Project type Fixed-scope project with potential for ongoing maintenance retainer. Experience level Expert Job description: We run a small acupuncture / wellness clinic and currently operate our billing system on a low-code platform (Base44). We are migrating OFF that platform and need an experienced healthcare-billing backend developer to rebuild our backend on infrastructure we own and control. The frontend already exists and can be exported. Your focus is the backend, database, and clearinghouse integration — rebuilt cleanly on a standard, HIPAA-compliant stack. This is a real production system handling real patient data (PHI) and real insurance claims, so accuracy, security, and compliance are non-negotiable. What you'll build A backend + relational database (PostgreSQL preferred) to replace our current low-code backend. Claim.MD clearinghouse integration — claim upload via their API, status/277CA handling, and ERA (835) retrieval. Migration of our existing claim quality-control logic, including: NCCI edits (e.g. handling 97xxx procedure pairs, modifier 59) Auto-modifier logic (GP, 59, etc.) ICD-10 validation (e.g. blocking retired codes) Duplicate-submission prevention (idempotency on submit) Frequency Code handling for corrected claims (837P resubmission code 7) Payer auto-routing based on member ID patterns Audit logging of every submit attempt with the actual success/failure reason (no silent failures) Import of our existing historical claim and patient data from exported JSON/CSV. Connecting the existing frontend to the new backend API. This is acupuncture / physical-medicine billing. Expect heavy use of 97-series CPT codes (97810, 97813, 97814, 97026, 97140, etc.), GP modifiers, and acupuncture-specific payer rules. Experience with PT / rehab / acupuncture billing is a strong plus. Required experience Hands-on EDI / X12 healthcare experience: 837P, 835, 277CA, 270/271, 999. Direct experience integrating with at least one clearinghouse (Claim.MD, Availity, Waystar, Office Ally, or similar). Claim.MD experience is a plus but not required. CMS-1500 / professional claim structure (loops, segments, modifiers). Building and operating a HIPAA-compliant environment (able to work under a signed BAA; experience with AWS / GCP / Supabase HIPAA setups). Backend development in Node/TypeScript (or your strong stack — tell us) + PostgreSQL. Nice to have NCCI / CCI edit implementation experience. EHR/PM integration experience (Athena, AdvancedMD, NextGen, eClinicalWorks, etc.). Prior migration off a low-code platform (Base44, Bubble, etc.). How we'll work We'll start with a small paid test task before committing to the full project — for example, taking a sample claim and correctly generating + submitting an 837P through Claim.MD. If that goes well, we move to the full rebuild on a fixed scope, with a possible ongoing maintenance retainer afterward. To apply, please answer briefly: Which clearinghouses have you integrated with, and how did you handle the API upload + 277CA acknowledgment loop? When a claim hits an NCCI edit, how do you decide between modifier 59 vs other resolutions? Where does Frequency Code 7 (corrected claim) go in an 837P file? How do you set up a HIPAA-compliant environment that you can sign a BAA for? Link one past healthcare-billing/EDI project you're proud of.