EDI Analyst
Posted 4 days ago by 1752296160
Negotiable
Outside
Remote
USA
Summary: We are seeking an experienced EDI Analyst for a long-term contract role focused on implementing and managing Electronic Data Interchange (EDI) processes specifically for healthcare claims adjudication systems. The position is based in Dublin, Ohio, or can be performed remotely, and is crucial for enhancing healthcare data integration and operations. The ideal candidate will have extensive experience in EDI implementations and a strong understanding of healthcare standards. This role offers the opportunity to significantly contribute to the efficiency of healthcare data operations.
Key Responsibilities:
- Lead the implementation and coordination of EDI processes for healthcare claims adjudication systems.
- Manage and integrate EDI transaction sets, including 837 (Claims) and 835 (Remittance Advice), ensuring compliance with healthcare standards.
- Collaborate with stakeholders, vendors, and payers to ensure seamless system integration and data accuracy.
- Develop and execute detailed implementation plans, including mapping, testing, validation, and system go-live processes.
- Troubleshoot technical issues, optimize configurations, and maintain compliance with EDI regulations.
- Provide ongoing support and improvements to the EDI system, ensuring operational efficiency.
- Analyze and document technical specifications and workflows to streamline integration processes.
- Monitor data transactions and address discrepancies to maintain data integrity.
- Coordinate with cross-functional teams to align EDI processes with broader organizational objectives.
Key Skills:
- Extensive experience in leading EDI implementations, particularly in healthcare claims adjudication systems.
- In-depth knowledge of EDI formats, including 837 (Institutional), 835, and related transaction sets.
- Strong understanding of healthcare claims processing and adjudication workflows.
- Proven ability to work independently and manage project timelines effectively.
- Excellent communication skills and the ability to collaborate across teams.
- Strong problem-solving capabilities and attention to detail.
- Familiarity with healthcare IT standards and regulations.
- Experience with integrating EDI systems into enterprise platforms such as CRMs, ERPs, or claim engines.
Salary (Rate): undetermined
City: Dublin
Country: USA
Working Arrangements: remote
IR35 Status: outside IR35
Seniority Level: undetermined
Industry: IT
Description
We are looking for an experienced EDI Analyst to join our team on a long-term contract basis. In this role, you will play a pivotal part in implementing and managing Electronic Data Interchange (EDI) processes for a healthcare claims adjudication system. This position is based in Dublin, Ohio, and offers the opportunity to contribute significantly to healthcare data integration and operations.
Responsibilities:
Lead the implementation and coordination of EDI processes for healthcare claims adjudication systems.
Manage and integrate EDI transaction sets, including 837 (Claims) and 835 (Remittance Advice), ensuring compliance with healthcare standards.
Collaborate with stakeholders, vendors, and payers to ensure seamless system integration and data accuracy.
Develop and execute detailed implementation plans, including mapping, testing, validation, and system go-live processes.
Troubleshoot technical issues, optimize configurations, and maintain compliance with EDI regulations.
Provide ongoing support and improvements to the EDI system, ensuring operational efficiency.
Analyze and document technical specifications and workflows to streamline integration processes.
Monitor data transactions and address discrepancies to maintain data integrity.
Coordinate with cross-functional teams to align EDI processes with broader organizational objectives.
Requirements
Extensive experience in leading EDI implementations, particularly in healthcare claims adjudication systems.
In-depth knowledge of EDI formats, including 837 (Institutional), 835, and related transaction sets.
Strong understanding of healthcare claims processing and adjudication workflows.
Proven ability to work independently and manage project timelines effectively.
Excellent communication skills and the ability to collaborate across teams.
Strong problem-solving capabilities and attention to detail.
Familiarity with healthcare IT standards and regulations.
Experience with integrating EDI systems into enterprise platforms such as CRMs, ERPs, or claim engines.
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