EDI Technical Analyst (Claims) - Hybrid

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

Qualifications

  • High School Diploma or GED required; Bachelor's degree in a related field preferred.
  • 2+ years of EDI experience supporting healthcare transactions.
  • Strong experience with QNXT is highly preferred.
  • Experience working with healthcare claims and EDI transactions (270/271, 834, 835, 837 preferred).
  • Strong SQL query development and database analysis skills.
  • Knowledge of healthcare EDI standards, HIPAA regulations, and data mapping methodologies.
  • Experience with testing tools such as SOAP UI and Postman.

Responsibilities

  • Support, troubleshoot, and resolve EDI production issues related to claims.
  • Analyze, map, and validate healthcare data exchanges including key EDI transactions.
  • Develop technical specifications and operational procedures.
  • Write and maintain SQL queries for support and reporting.
  • Perform root cause analysis and collaborate to resolve data issues.
  • Create and execute test plans, and support defect resolution activities.
  • Utilize monitoring tools to validate system performance and troubleshoot issues.

Benefits

  • Hybrid work opportunity with flexibility to work remotely and on-site.
  • Collaborative working environment promoting continuous improvement.
  • Opportunity to work with advanced technology tools in data monitoring and analysis.
  • Participation in project planning and implementation activities.
  • On-call support rotation providing diverse exposure to production support challenges.
Full Job Description
Location: The position is a Hybrid role at least once a week in Phoenix, AZ 85021

Description:
The EDI Technical Analyst (Claims) is responsible for supporting, analyzing, testing, and maintaining EDI transactions, integrations, and data exchange processes that support healthcare claims operations. This role partners with business and technical teams to troubleshoot production issues, develop technical documentation, create data mappings, support testing efforts, and ensure the successful exchange of healthcare data between trading partners. The ideal candidate combines strong analytical skills, EDI expertise, SQL proficiency, healthcare systems knowledge, and experience supporting payer platforms such as QNXT to drive operational efficiency and data integrity.


What You Will Do:
  • Support, troubleshoot, and resolve EDI production issues related to claims and trading partner transactions.
  • Analyze, map, and validate healthcare data exchanges including 270/271, 834, 835, and 837 transactions.
  • Develop technical specifications, mapping documents, process flows, and operational procedures.
  • Write and maintain SQL queries for production support, reporting, testing, and data validation.
  • Perform root cause analysis and collaborate with internal teams to resolve data and integration issues.
  • Create and execute test plans, process test files, document results, and support defect resolution activities.
  • Utilize tools such as Splunk, App Insights, SOAP UI, and Postman to monitor, troubleshoot, and validate system performance.
  • Support API integrations, ETL processes, and enterprise data exchange initiatives.
  • Develop dashboards, reports, and monitoring solutions to ensure data quality and transaction integrity.
  • Participate in project planning, implementation activities, and continuous process improvement initiatives.
  • Maintain compliance with HIPAA requirements and healthcare EDI standards including TR3, CAQH CORE, and Blue Exchange guidelines.
  • Participate in on-call support rotations and production incident response activities.

You Will Be Successful If:
  • You have hands-on experience supporting QNXT, healthcare claims processing, and EDI transaction workflows within a payer environment.
  • You have experience supporting healthcare EDI transactions and claims-related data exchanges.
  • You can quickly identify, troubleshoot, and resolve complex data and integration issues.
  • You possess strong SQL and data analysis skills and can confidently work with large datasets.
  • You effectively translate business requirements into technical solutions and documentation.
  • You are comfortable working across multiple systems, integrations, and business stakeholders.
  • You thrive in a fast-paced environment with competing priorities and deadlines.
  • You proactively identify opportunities to improve operational processes, monitoring, and reporting.
  • You demonstrate strong communication skills and can explain technical concepts to both technical and non-technical audiences.
  • You are committed to delivering high-quality solutions that improve customer and business outcomes.

What You Will Bring:
  • High School Diploma or GED required; Bachelor's degree in Computer Science, Information Systems, Business, or related field preferred.
  • 2+ years of EDI experience supporting healthcare transactions.
  • Experience working with healthcare claims, enrollment, eligibility, or payment transactions (270/271, 834, 835, and 837 preferred).
  • Strong experience with QNXT is highly preferred.
  • Experience supporting healthcare payer environments, claims processing systems, and trading partner integrations.
  • Experience in data analysis, data management, integration, and reporting.
  • Strong SQL query development and database analysis skills.
  • Knowledge of healthcare EDI standards, HIPAA regulations, and data mapping methodologies.
  • Experience with testing tools such as SOAP UI and Postman.
  • Familiarity with monitoring and logging tools such as Splunk and App Insights.
  • Understanding of API integrations, ETL processes, cloud platforms (AWS, Azure), and enterprise application environments.
  • Knowledge of Edifecs EDI platform is a plus.
  • Excellent analytical, troubleshooting, technical documentation, and problem-solving skills.
  • Ability to manage multiple priorities while working independently and collaboratively across teams.
  • Strong communication skills with the ability to translate technical concepts for business and operational stakeholders.

About Impresiv Health

Impresiv Health is a healthcare technology company that provides software solutions to healthcare providers. The company's products include a patient engagement platform, a telemedicine platform, and a virtual care platform. Impresiv Health was founded in 2019 and is headquartered in Wilmington, Delaware. The company has raised $1.8 million in funding to date.
Learn more about Impresiv Health
Size
50 employees
Industry
Founded
2019

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