EDI 837 Developer/Analyst (Healthcare)

Job Description

Job Title: EDI 837 Healthcare Billing Analyst (Part-Time, Contractual) Location: Remote Position Type: Part-Time, Contractual (Hourly Paid) Job Description: We are seeking a skilled EDI 837 Developer/Analyst to serve as a Subject Matter Expert (SME) in the development of a healthcare billing product. This position involves working closely with the product development team to analyze, interpret, and utilize EDI (Electronic Data Interchange) 837, 999, and 277 files. The ideal candidate will have extensive experience in healthcare billing, claims processing, and understanding EDI 837 Companion Guide/Mapping Files/specifications provided by healthcare providers and insurance companies. Responsibilities: Act as the SME for EDI 837 transactions, providing expert insights and guidance to the product development team. Analyze and interpret healthcare billing requirements from providers and payers to ensure accurate implementation. Review and validate EDI 837, 999, and 277 files for compliance with HIPAA and industry standards. Collaborate with developers, testers, and stakeholders to design and optimize workflows for the healthcare billing product. Assist in mapping specifications and implementing solutions for EDI transactions. Provide recommendations for improving claims submission and processing efficiencies. Test and troubleshoot EDI file formats to ensure accuracy and successful integration with third-party systems. Document requirements, processes, and best practices for EDI-related activities. Qualifications: Proven experience with EDI 837, 999, and 277 file formats, including mapping and processing. In-depth knowledge of healthcare billing, claims lifecycle, and HIPAA compliance. Ability to read, analyze, and interpret technical specifications provided by healthcare providers and insurance companies. Strong understanding of ANSI X12 standards and EDI implementation guidelines. Excellent problem-solving skills and attention to detail. Strong communication skills, with the ability to convey complex technical information to non-technical team members. Experience with healthcare payer systems, clearinghouses, or related technology is a plus. Preferred Qualifications: Previous experience as a consultant or contractor in a similar role. Familiarity with healthcare billing platforms and data integration tools. Knowledge of SQL or scripting for data validation and analysis.