EDI Business Implementation Analyst

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

May 20, 2025 - 17:00

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