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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 healthcare delivery and patient care
- Work with a dedicated team focused on serving vulnerable populations
What to Expect (Job Responsibilities):
- Own the end-to-end strategy for eligibility data presentation, including how to simplify complex benefit structures for front-line users
- Lead discovery with stakeholders to define how eligibility and benefit information should appear in relevant portals and reports
- Analyze 270/271 X12 files to document detailed parsing logic for eligibility and benefits segments
- Define and maintain business rules to normalize and prioritize multiple eligibility segments
- Provide subject matter expertise and training to teams on interpreting eligibility-related data
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 and financial accumulators
- Experience creating functional specifications and mapping documents for integrating EDI data
- Proficiency with advanced Excel and familiarity with SQL or similar tools
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
- Exposure to other HIPAA X12 transactions to understand end-to-end data flow
#HealthcareServices #EDI #BusinessAnalyst #CareerOpportunity #HealthcareInnovation
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