Essen Health Care
Business Analyst, Healthcare EDI
What's your preference?
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
- Work collaboratively with diverse teams in a supportive environment
- Chance to make a meaningful impact in the healthcare delivery system
- Engage in innovative projects related to eligibility and benefits transactions
What to Expect (Job Responsibilities):
- Own the end-to-end strategy for eligibility data presentation, including simplification of complex benefit structures
- 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, payer companion guides, and CAQH CORE operating rules for eligibility 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 such as plan types, covered services, and benefit limitations
- Experience creating functional specs, mapping documents, and business rules for EDI data integration
- Proficiency with advanced Excel and familiarity with SQL or similar tools for validating eligibility data
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
- Exposure to other HIPAA X12 transactions to understand end-to-end data flow
#HealthcareServices #EDIAnalysis #CareerOpportunity #CompetitivePay #InnovationInHealthcare
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Where Care Comes Together.
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.