EDI Analyst

Electronic Data Exchange

• Manage daily EDI operations, ensuring the proper handling and processing of eligibility and benefit transactions.
• Monitor, reconcile, and troubleshoot inbound and outbound EDI files, including 834 benefit enrollment files.
• Coordinate system upgrades, file transfers, and resolve EDI transaction issues efficiently.
• Collaborate with carriers, vendors, and internal teams to implement fixes and enhancements.

Business Process Improvement

• Continuously identify opportunities to improve data accuracy, system efficiency, and operational workflows.
• Develop and document Standard Operating Procedures (SOPs) to streamline EDI processes.
• Lead initiatives to implement process improvements, reducing risks and increasing productivity.
• Communicate key changes and updates effectively to all stakeholders.

Customer Support & Portal Management

• Oversee functionalities of customer-facing portals (WERC, PERC, OPIS, Health View) ensuring their reliable performance.
• Act as a point of contact for vendors and clients regarding portal and enrollment system issues.
• Assist with technical support requests, including account management, security settings, and testing activities.
• Collaborate across departments to facilitate new client integrations and enrollment testing.

Other Duties

• Promote a culture of curiosity, accountability, and collaboration to help meet organizational goals.
• Maintain a HIPAA-compliant workstation, ensuring the security and confidentiality of protected health information.
• Perform additional duties as assigned to support organizational success.

• Bachelor’s degree in Management Information Systems (MIS), Computer Science, Healthcare Administration, or related field; or three (3) years of relevant experience.
• Strong Advanced-intermediate Excel Skills
• Solid experience working with healthcare EDI transactions, particularly within health benefits administration.
• Proficiency in EDI software, tools, and platforms, with strong understanding of data flow, mapping, and troubleshooting.
• Knowledge of HIPAA regulations, healthcare eligibility, and enrollment processes.
• Strong communication skills, capable of collaborating across technical and non-technical teams.
• Demonstrated project management skills, from planning to execution, with attention to detail.
• Ability to analyze and resolve complex technical issues efficiently.

Pulled from the full job description

• 401(k)
• Health insurance
• Vision insurance
• Dental insurance
• Life insurance
• Disability insurance, Remote. Must live in Pacific, Mountain or Central time zones. Work Schedule: Monday-Friday 8:00am- 5:00pm Hourly pay: $37.00