Full-Time Healthcare EDI Analyst (Remote)

• Monitor, troubleshoot, and maintain EDI transactions (e.g., 837, 835, 270/271, 276/277)
• Collaborate with IT and external vendors to resolve EDI transmission issues
• Ensure timely and accurate data exchange between systems and trading partners
• Develop and maintain documentation for EDI processes and workflows
• Analyze EDI data for discrepancies and implement corrective actions

• Assist in the design and management of insurance coverage verification and insurance discovery technology using automated tools and manual processes
• Maintain accurate insurance information in internal systems
• Work with payers to resolve coverage issues and discrepancies
• Assist in the development of policies and procedures related to insurance verification
• Support audits and compliance initiatives related to insurance coverage

• Partner with Revenue Cycle, IT, and Compliance teams to ensure data integrity and operational alignment
• Provide training and support to staff on EDI and insurance coverage processes

• Bachelor's degree in Computer Sciences, Healthcare Administration, Information Systems, Business, or related field
• 3+ years' experience in healthcare EDI operations with an emphasis on eligibility and insurance discovery required
• 3+ years' experience with HIPAA data and associated transaction sets and payer requirements required
• 2+ years' experience with clearinghouses, payer EDI, and healthcare management systems (e.g., Epic, Cerner, or similar) required
• 3+ years' experience with EDI formats and standards (X12, HL7) required
• 2+ years' familiarity with healthcare billing and coding practices required

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