EDI Analyst, Transaction Specialist

This is a fully remote position, open to applicants in Texas.

📋 Description

• Manage functional EDI workflows, partner requirements, and data validation protocols.

• Analyze and troubleshoot transaction sets including 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA.

• Evaluate SNIP compliance, companion guides, and validation rules specific to partners.

• Document mapping and logical requirements for new partnerships and integration modifications.

• Collaborate with business stakeholders to resolve issues and assess operational impacts.

• Assist with audit and compliance evaluations while upholding data-quality standards.

• Work closely with EDI Analysts, DevSecOps Engineers, cloud teams, and business units.

• Identify the root causes of transaction errors and rectify mapping discrepancies.

• Troubleshoot rejections from payers or state systems and address middleware/API challenges.

• Query SQL databases to reconcile raw EDI data with stored information.

⛳️ Requirements

• A bachelor’s or master’s degree in computer science, engineering, or a relevant technical field is required; equivalent practical experience will be considered.

• Edifecs certification is necessary.

• At least 8 years of experience with Edifecs products in EDI, healthcare, or enterprise application operations.

• Minimum of 8 years of EDI/HIPAA experience.

• Strong understanding of payer/provider workflows is essential.

• Capability to interpret loops, segments, and element-level errors.

• Familiarity with Edifecs Transaction Management or similar tools is required.

• Proficient knowledge of X12 / HIPAA EDI transaction structure, rules, and field-level details for 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA.

• Understanding of EDI X12 loop, segment, and element interpretation, SNIP validation levels 1–7, companion guide analysis, and segment or element-level error assessment.

• Experience in interpreting Edifecs XEngine validation results, processing rules, and transaction profiles.

• Familiarity with SpecBuilder maps and implementation guides.

• Ability to identify issues from Edifecs routes, profiles, or rulesets.

• Capacity to interpret Edifecs logs and error codes at the functional level.

• Skilled in identifying transaction error root causes, resolving mapping mismatches, troubleshooting payer or state-system rejections, and reviewing parsed EDI structures in SQL databases.

• Understanding of inbound/outbound workflow architecture.

• Experience with AS2, SFTP, and HTTPS communication protocols.

• Ability to validate data sent to and received from non-X12 partners.

• Proficient in identifying issues caused by middleware layers or APIs.

• Experience querying SQL for transaction specifics.

• Ability to validate payloads, timestamps, statuses, and error flags.

• Capability to reconcile discrepancies between raw EDI and stored data.

• Strong communication skills to convey technical architecture decisions and trade-offs to non-technical stakeholders.

• Experience in translating business reporting needs into technical data models.

• Familiarity with agile methodologies (Scrum, Kanban) and JIRA.

• Strong documentation practices, including transaction flow documentation, error trend reports, escalations, SOPs, and partner reference guides.

• U.S. Citizenship is required, with the ability to obtain and maintain a Public Trust clearance.

🏝️ Benefits

• Comprehensive health insurance plans.

• Retirement savings plan with company matching.

• Flexible work arrangements.

• Opportunities for professional development and certifications.

• Paid time off and holidays.