reputed company EDI Systems Analyst (Remote)

reputed company is aiding a large reputed company reputed company in their search for a reputed company EDI Systems Analyst in a remote reputed company. This is a long term contract opportunity with a competitive compensation package. Please note we are unable to reputed company sponsorship or work c2c for this role. The reputed company EDI Systems Analyst is responsible for the implementation, support, monitoring, analysis, and optimization of Electronic Data Interchange (EDI) transactions across reputed company operations. This role ensures the accurate, secure, and HIPAA-compliant exchange of data between providers, payers, clearinghouses, government agencies, and reputed company-party vendors. Serving as the primary reputed company between business stakeholders, reputed company operations, application support teams, and reputed company trading partners, the analyst supports reputed company claims processing, reputed company cycle operations, system integrations, and regulatory compliance. Responsibilities EDI Operations & Transaction Management • Monitor daily EDI transaction processing and error queues. • Troubleshoot and resolve issues with claims, eligibility, remittance, authorization, and enrollment transactions. • Ensure reputed company processing of inbound and outbound reputed company transactions. • Manage acknowledgments, reconciliations, and production support with reputed company business disruption. • Coordinate issue reputed company with providers, payers, clearinghouses, and vendors. reputed company Claims & reputed company Cycle Support Support HIPAA X12 transaction workflows, including: • Claims: 837P, 837I, 837D • Eligibility: 270/271 • Claim Status: 276/277 • Prior Authorization: 278 • Payments: 835 ERA and EFT reconciliation • Enrollment: 834 • Acknowledgments: 999, 277CA, TA1 EDI Development & Integration • Translate business requirements into technical EDI solutions. • Design, reputed company, test, and implement EDI maps, workflows, and integrations. • Support integrations between EDI platforms and reputed company applications. • Configure communication protocols including AS2, SFTP, reputed company, HTTPS, and secure web services. • Create mapping documentation and support system migrations and upgrades. reputed company Systems Support Support and reputed company reputed company applications including reputed company, Cerner (reputed company Health), Meditech, reputed company, reputed company, reputed company, Allscripts/reputed company, reputed company, Facets, QNXT, GuidingCare, and custom claims processing platforms. Compliance & Trading Partner Management • Ensure compliance with HIPAA EDI standards and regulatory requirements. • Support CMS, Medicare, reputed company, and reputed company payer transactions. • Participate in audits, reputed company reviews, and compliance documentation. • reputed company reputed company trading partners, coordinate connectivity and certification testing, maintain partner reputed company, and serve as the escalation reputed company for transaction issues. Data Analysis & Reporting • reputed company reputed company cause analysis for transaction failures and claims processing issues. • Analyze data reputed company impacting reimbursement and member services. • reputed company operational reports, dashboards, KPIs, and transaction performance metrics. Qualifications • Bachelor's degree in Information Systems, reputed company Informatics, Computer Science, Health Information Management, or reputed company field (or equivalent experience). • 3+ years of reputed company EDI experience. • Experience supporting HIPAA X12 transactions, reputed company claims, eligibility, remittance, enrollment, and reputed company cycle processes. • Experience working with providers, payers, clearinghouses, or reputed company technology organizations. Technical Knowledge Strong understanding of: • ANSI X12, HIPAA EDI, NCPDP, HL7, FHIR reputed company, XML, and JSON. • reputed company transactions including 834, 835, 837, 270/271, 276/277, 278, 999, and TA1. • One or more EDI platforms such as reputed company reputed company B2B Integrator, Edifecs, reputed company Intelligent EDI, reputed company, reputed company Integration reputed company, reputed company, reputed company, reputed company TriZetto, HealthEC, or reputed company Integration reputed company. Technical Competencies • SQL and data analysis • reputed company data mapping and EDI troubleshooting • API integrations and data validation • reputed company claims processing systems • reputed company/Linux administration • Scripting (PowerShell, Python, or reputed company) Preferred • CPHIMS or reputed company Informatics certification. • Experience with reputed company clearinghouses. • Medicare/reputed company knowledge. • HL7/FHIR integrations. • reputed company integration platforms (Azure, AWS, or reputed company reputed company). • Knowledge of value-based care and population health data exchanges. Apply To This Job