Essen Medical Associates
Business Analyst, Healthcare EDI
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Job Description
- Req#: 2059
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $55 per hour
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on eligibility verification workflows
- Work with a dedicated team committed to improving healthcare delivery
What to Expect (Job Responsibilities):
- Own the end-to-end strategy for eligibility data presentation, ensuring clarity and usability for front-line users
- Define the canonical internal data model for eligibility and benefit information across products and workflows
- Analyze 270/271 X12 files to document detailed parsing logic for eligibility and benefits segments
- Create and execute test cases for 270/271 flows, including positive/negative scenarios and regression testing
- Ensure compliance with HIPAA and CAQH CORE operating rules for eligibility and benefits transactions
What is Required (Qualifications):
- 3–5+ years of experience as an EDI Analyst, Business Analyst, or similar role in healthcare, with hands-on work on ANSI X12 transactions
- Strong experience with 270/271 eligibility and benefits transactions, including reading raw X12 files
- Solid understanding of health insurance concepts, including plan types, copay, coinsurance, and deductibles
- Proficiency with advanced Excel and familiarity with SQL or similar tools for validating eligibility data
- Strong communication skills and ability to translate technical EDI content into clear requirements
How to Stand Out (Preferred Qualifications):
- Experience in provider revenue cycle, registration, scheduling, or prior authorization operations
- Prior work with payer or clearinghouse 270/271 companion guides and real-time eligibility APIs
- Background working in Agile product teams, writing user stories and acceptance criteria for eligibility features
#HealthcareServices #EDI #BusinessAnalyst #CareerOpportunity #HealthcareDelivery
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