EDI Analyst

Provides support for the EDI Operations department by interfacing with internal and external customers including business analysts, software developers, project managers, trading partners, and software vendors. This role is responsible for managing a range of EDI transactions including enrollment, claims, financial, and eligibility transactions using ANSI X12 HIPAA compliant formats. Provides technical support for the implementation of EDI connections with external parties; responds to inquiries related to EDI transactions; conducts analysis of EDI transactions; and provides issue resolution when necessary. Handles multiple enhancement requests and projects.

Essential Functions:

• Demonstrate knowledge of EDI standard formats and communicate complex data exchange concepts to internal and external parties. Interface professionally with various internal and external customers including Operations, Sales, Marketing, IS, and Trading Partners to understand and process work requests.
• Responsible for the implementation of electronic data interchange connections between client and external parties. Support ongoing implementations in post-production, including error identification/resolution, continuous improvement, and pro-active communication with the trading partners and providers to reduce/prevent errors.
• Verify and monitor EDI processes. Troubleshoot and resolve EDI related issues. Develop and maintain procedural documentation. Follow-up comprehensively with all stakeholders during issue remediation process to assure that delays are minimized and the process runs smoothly.
• ssist in defining application enhancements and upgrades.
• Perform application configuration, mapping, and monitoring of EDI transactions and processes.
• Support application testing effort by performing user acceptance testing (UAT) and assisting in defect resolution.
• Provide on-call support as necessary.

• Must be able to facilitate SFTP connection setup between internal and external partners
• Must be able to support file/transaction processing, including error triage and resolution
• Must demonstrate knowledge of EDI 834 standard
• Relevant experience Analyzing EDI data to identify content and/or formatting issues
• Relevant experience Using SQL queries to retrieve and/or display data
• Must have the ability to communicate complex data exchange concepts to internal and external partners
• Experience Reading/analyzing/formatting/translating EDI data
• Experience Implementing EDI setup and mapping

Nice to Have

• bility to create/run SQL queries
• Knowledge to interpret query results
• Experience in the healthcare industry
• Experience with Facets software or a similar healthcare enrollment/claims management software system

NO C2C