EDI Analyst (ANSI X12 834)

• Work with ANSI 834 enrollment files (inbound/outbound) for member enrollment processing.
• Perform validation, testing, and auditing of enrollment files to ensure data accuracy and completeness.
• Collaborate with internal teams and external submitters for end-to-end testing of enrollment transactions
• Send, receive, and process enrollment files, identifying and resolving any discrepancies or errors.
• Ensure accurate and timely enrollment of members into target systems (e.g., Facets).
• Troubleshoot and resolve data or file-related issues impacting enrollment processing.
• Partner with stakeholders to ensure smooth execution of enrollment workflows.
• Support UAT, system testing, and validation activities related to enrollment

We are seeking experienced professionals with strong knowledge of ANSI 834 Enrollment processes to support member enrollment operations. The role primarily focuses on handling automated electronic enrollment files, validating data, resolving errors, and ensuring accurate member enrollment into healthcare systems.

Mandatory skills

• Hands-on experience or strong knowledge of ANSI 834 Enrollment transactions.

• Understanding of member eligibility and enrollment processes in the healthcare domain.

• Experience working with electronic data interchange (EDI) files.

• Strong analytical and problem-solving skills for data validation and error resolution.

• Experience in testing and auditing enrollment processes

Good to have skills: -

• Prior experience in the healthcare industry Familiarity with Facets system (nice to have, not mandatory)
• Exposure to partner testing and file integration workflows Knowledge of compliance and data accuracy standards in healthcare enrollment.