Senior Healthcare EDI Analyst

Summary

Join Experian Health as an EDI Analyst II and manage the electronic exchange of healthcare information. You will monitor and troubleshoot EDI transactions, ensuring HIPAA compliance. Collaborate with internal and external teams to optimize product solutions and support process improvements. Leverage automation and AI technologies while developing and maintaining EDI documentation. Conduct training and provide support to internal teams. This role requires strong knowledge of transaction sets and experience with EDI protocols and standards.

Requirements

• 5 years' experience as an EDI analyst, business analyst, implementation, or client/payer-side (payer or hospital/health system) experience in healthcare revenue cycle management software and technology required
• Knowledge of EDI protocols and standards, specifically 27x and 83x healthcare transactions
• Proficiency in EDI standards (X12, EDIFACT, HL7), EDI mapping tools, and related software applications
• Experience with business processes and workflows related to healthcare reimbursement and patient access
• Experience using Salesforce, Atlassian JIRA, Microsoft 365 applications, with great proficiency in excel (can perform complex functions) and other data analytics tools
• Familiar with Agile methodologies, including scrum and Kanban
• Strong knowledge of transaction sets (270/271, 276/277, 278, 837, 835) and Patient Estimates

Responsibilities

• Monitor and troubleshoot EDI transactions to resolve errors promptly
• Maintain and grow direct connections with product and technology teams
• Collaborate with internal teams and external partners on EDI issues
• Ensure EDI transactions comply with HIPAA regulations
• Communicate EDI connectivity issues with stakeholders
• Identify process improvement opportunities with IT, operations, and business teams
• Communicate with all partners regarding EDI, API, and web/screen capture connectivity issues
• Develop and maintain EDI documentation, including companion guides, smart checklists, payer lists, and internal process documentation
• Host external working sessions with trading partners, vendors, and clients
• Provide training and support to internal teams on EDI processes and best practices
• Support automation and AI technologies
• Leverage internal relationships to resolve transaction issues

Benefits

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays