Senior EDI Analyst

Sr. EDI Analyst US/Remote Job Summary A Sr. EDI Analyst expert with 837 transaction experience in healthcare is responsible for designing, implementing, and managing electronic data interchange (EDI) transactions—particularly the ANSI X12 837 health care claim format, which is critical for submitting medical claims to payers Duties & Responsibilities • Analyze, design, and implement EDI solutions specifically for 837 transactions related to healthcare claims, ensuring proper parsing and mapping according to business and regulatory requirements. • Monitor and troubleshoot EDI transactions, resolving errors promptly and ensuring compliance with HIPAA and industry standards. • Collaborate with technical, billing, and compliance teams, as well as external trading partners, to facilitate seamless data exchanges and timely claim submissions. • Maintain comprehensive EDI documentation, including companion guides, payer lists, and internal process workflows. • Develop and conduct end-to-end testing of transactions, validating technical specifications and business rules. • Guide and mentor team members on mapping techniques, regulatory updates (ANSI 4010 to 5010), and process improvements. • Support onboarding of new trading partners, and ensure data integrity and security across all EDI transactions. • Stay updated on healthcare regulatory changes and adapt EDI processes accordingly. Requirements & Qualifications • Deep expertise in EDI transaction sets, especially 837 (claims), along with related formats like 835 (payments), 834 (enrollment), etc. 1 • Proficiency in EDI mapping, transformation, and validation using industry-standard tools and technologies. • Strong analytical and troubleshooting skills with healthcare claims and encounter data. • Knowledge of HIPAA regulations, claim submission workflows, and healthcare coding systems (ICD, CPT, HCPCS). • Effective communication and collaboration skills to work with multidisciplinary teams and external entities Evaluation Criteria

• Data-driven and detail-oriented mindset.
• Strong communication and stakeholder engagement skills.
• Ability to manage multiple priorities and deliver quality results on time.
• Proactive in identifying data issues and proposing improvement solutions.

Physical Work Essentials: NA Please send your resume and salary requirements to View email address on click.appcast.io Elevance Systems, Inc. is an equal opportunity employer, which prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. 2