EDI Business Implementation Analyst

Job Summary

A company is looking for an EDI Business Implementation Analyst to lead eBusiness implementations and coordinate activities across multiple functional areas.

Key Responsibilities

• Coordinate and support the implementation of new Medicaid, Commercial, and Marketplace lines of business
• Manage setup, testing, and validation of EDI Transactions to ensure compliance with HIPAA and payer-specific requirements
• Develop and document business requirements for claims intake and processing, ensuring alignment with regulatory and operational standards

Required Qualifications

• Bachelor's degree or equivalent years of relevant work experience
• Minimum of five (5) years of health care operations experience in insurance, managed care, or related industry
• 3-5 years of SQL experience, including the ability to write and execute complex queries
• Advanced knowledge of healthcare EDI files and ANSI X12 guidelines
• Working knowledge of managed care and health claims processing