Electronic Data Interchange Analyst(EDI)

Job Summary:

EDI Analyst

Key Responsibilities:

• Analyze and manage EDI file processes including 837 (claims) and 835 (remittance) transactions.
• Support the onboarding of new clients by configuring EDI integrations and validating data exchange protocols.
• Collaborate with engineering, client delivery teams, and QA to troubleshoot EDI-related issues and ensure successful data transmissions.
• Partner with:

• Red Team

  on legacy systems support (e.g., Impact).

• Yellow Team

  on forward-looking initiatives like centralized integrations and web portal enhancements.
• Support ongoing platform operations, including resolving production issues, implementing enhancements, and participating in system upgrades.
• Conduct root cause analysis for EDI-related issues and recommend process improvements.
• Act as a

  Subject Matter Expert (SME)

  on healthcare claims adjudication and EDI transaction standards.
• Maintain up-to-date documentation for EDI workflows, data mappings, and system configurations.

Required Qualifications:

• Strong understanding of EDI standards

  , especially 837 (institutional and professional claims) and 835 (remittance) formats.
• Experience working with healthcare claims processes, including adjudication and repricing.
• Familiarity with HIPAA compliance and healthcare data privacy regulations.
• Ability to analyze raw EDI data, identify errors, and coordinate resolutions.
• Experience supporting or working within Agile teams (e.g., attending standups, working in sprints).
• Strong communication skills to effectively engage with technical and non-technical stakeholders.

Preferred Qualifications:

• Experience working with legacy claims systems such as

  Impact

  .
• Exposure to

  payer

  or

  TPA environments

  , or claims processing platforms.
• Familiarity with integration platforms or healthcare web portals.
• Agile or EDI-related certification is a plus (e.g., ANSI X12, CAQH CORE, etc.).