Job Description

• Execute recurring operational tasks to generate encounter data files; monitor daily production jobs, troubleshoot issues, and drive error investigation through resolution.
• Design, build, and maintain X12 EDI 837 encounter processing workflows.
• Ensure solutions comply with HIPAA and X12 standards, including state- and client-specific implementation guides.
• Perform unit, integration, and regression testing for EDI processes and related data flows.
• Interpret and reconcile 999, 277, 835, and custom state/client response files associated with encounter submissions.
• Develop and maintain data mappings between internal application data models and EDI segments/loops.
• Implement corrective actions to remediate defects and reduce or eliminate repeat issues.
• Partner with external clients and internal operational teams on new client implementations and changes to existing submissions.
• Create and execute EDI test plans and provide clear, timely status updates to internal stakeholders and clients.

• 3+ years of relevant experience in the healthcare industry
• 3+ years of experience in a data analyst role, preferably supporting healthcare EDI.
• 1+ years of experience developing post-adjudication X12 837 files (required).
• 1+ years of SQL experience.
• Working knowledge of HIPAA X12 standards, specifically the 837 claim/encounter transaction.
• Strong attention to detail with the ability to analyze client needs and accurately document processes.
• Excellent analytical, troubleshooting, and communication skills.
• Experience with IBM Sterling B2B Integrator is preferred.