EDI Analyst and Developer

Keylent, Inc.

$70K — $95K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of experience as an EDI Analyst/Developer in the healthcare sector
  • Expertise in EDI standards, particularly ANSI X12
  • Solid grounding in SQL and relational databases
  • Proficient with ETL/EDI toolsets and XML Schema
  • Experience in data mapping, integration, and transformation processes
  • Hands-on experience with standard X12 transactions (e.g., 834, 837)
  • Strong troubleshooting skills with a focus on quality control.

Responsibilities

  • Analyze and develop EDI and data integration processes based on partner requirements
  • Ensure compliance of data integration designs with overall design components
  • Manage data transformation business rules and evaluate data impact
  • Conduct EDI system testing and quality assurance checks
  • Identify and resolve coding defects found during testing processes
  • Review and correct daily errors in inbound and outbound EDI transactions
  • Communicate effectively with clients and vendors to resolve issues and findings.

Benefits

  • Opportunity to work with cutting-edge EDI and ETL technology
  • Collaborative work environment with cross-departmental interaction
  • Emphasis on professional development with potential for growth in the healthcare industry
  • Exposure to a variety of complex systems and challenges
  • Commitment to data security and HIPAA compliance.
Full Job Description
Visa status: U.S. Citizens and those authorized to work in the U.S. are encouraged to apply.
Tax Terms: W2, 1099
Corp-Corp or 3rd Parties: Yes

Job description
EDI Analyst and Developer

Health EDI ANSI X12, XML Schema, ETL&EDI toolsets , SQL, Management Studio,
Health insurance experience Expert in EDI standards and implementation
Deep EDI ANSI X12 knowledge
Good knowledge of web services, XML and defining schemas using DTD/XSD
Perform EDI mapping and end to end test
Hands on experience in SQL Server / relational databases
Extensive experience integrating standard X12 transactions (834, 837, 835, 820, 270, 271, 276, 277) into internal and external systems
Experience in implementing EDI/ETL processes
Experience with various EDI and ETL toolsets
Experience with XML, X12 EDI Standards and Transactions, etc.
Experience with health care insurance or health care vendor organizations desirable

Analyze EDI and data integration/transformation requirements from business partners and develop processes to meet these requirements
Ensure data integration design and implementation is in accordance with other design components and meets end-state requirements
Apply business rules used to govern data transformations based on upstream and downstream data impact
Perform EDI system testing and quality control checks
Resolve code defects discovered during testing and implement corrective solutions
Review and correct daily errors for inbound EDI transactions and retransmit outbound EDI documents
Evaluate user requests for new and modified EDI applications, programs, processes, and maps
Manipulate data sets as needed for testing, correction, or knowledge building
Implement, maintain, and monitor EDI systems
Develop data integration components including EDI, data mapping, translation and interface
Review X12 files for issues including but not limited to: balancing, structure, syntactical, data type and content errors; then develop and execute strategies to solve them.
Troubleshooting activities include querying database using SQL Management Studio to review stored values and/or using a text editor to manually review data files sent by Payer clients
Support Payer and Provider client implementation activities by generating 835s files, reviewing their content and then presenting findings to clients/departments
Respond to inquiries regarding issues, claims, payments, and/or clearinghouse activities
Work closely with other departments on communication issues related to customer and third-party vendor connectivity
Communicate with vendor contacts to identify file issues and then disseminate the resolutions to the provider or payer
Maintain compliance with all HIP nd general data security standards

Excellent analytical and problem solving skills.
Understanding of complex information and requirements.
Ability to explain complex systems in simple terms.
An ability to work to tight deadlines and within constraints.
Excellent customer service skills
Excellent oral and written communication skills
Excellent ability to work alone and as a team member

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