Experian

Healthcare EDI Analyst - Payer Connectivity (Remote)

Experian$90K — $120K *
US-AnywhereRemote in Costa Mesa, CA
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years in business analysis, implementation, or healthcare technology/RCM experience.
  • 3+ years dealing with healthcare eligibility and benefits in hospital or physician workflows.
  • Strong understanding of EDI transactions: 270/271, 276/277, 278, 837, and 835.
  • Familiarity with payer connectivity models, including AS2, SFTP, APIs, and FHIR integrations.
  • Ability to interpret payer requirements and translate them into connectivity solutions.
  • Proficient in analyzing healthcare transaction data and diagnosing connectivity issues.
  • Experience with Microsoft 365, Salesforce, Atlassian Jira, and data reporting tools.

Responsibilities

  • Establish and implement connectivity solutions for new direct or trading partners.
  • Maintain accurate payer connectivity data including IDs, availability, and connection types.
  • Act as the subject matter expert for payer connectivity and EDI-related issues.
  • Collaborate with internal teams and external partners to enhance connectivity operations.
  • Document workflows, findings, and issue resolutions in established systems.
  • Monitor and validate new payer connections for effective transaction exchanges.
  • Analyze reports and tickets to identify trends and areas for improvement.

Benefits

  • Great compensation package and bonus plan.
  • Core benefits: medical, dental, vision, and matching 401K.
  • Flexible work environment: remote, hybrid, or in-office options.
  • Flexible time off policy including volunteer time off and paid holidays.
Full Job Description
The EDI Analyst - Payer Connectivity establishes, maintains, and optimizes payer and trading partner connections that support reliable electronic healthcare transactions. You will research payer requirements, implements and validates connectivity solutions, maintains accurate payer data, and resolves transaction issues across supported workflows. You will be a subject matter expert and escalation point, partnering with our teams and external partners to improve connectivity reliability, scalability, and operational efficiency. You'll have opportunity to: • Research payer requirements and establish new direct or trading partner connectivity solutions.• • Maintain payer connectivity data, including payer IDs, transaction availability, connection type, and status. • Be the subject matter expert and escalation point for payer connectivity, EDI, API, and web/screen capture issues. • Partner with Product, Clearinghouse, Implementation, Engineering, Support, vendors, and trading partners to support setup, troubleshooting, and optimization. • Document payer lists, workflows, requirements, research findings, issue resolutions, and reference materials in established systems. • Validate and monitor new payer connections to ensure successful transaction exchange. • Analyze reporting, dashboards, Salesforce cases, and Jira tickets to identify trends, risks, and improvement opportunities. • Support process improvement, automation, and AI-driven projects that improve monitoring, data accuracy, and workflow efficiency. • Provide guidance and training on payer connectivity processes and best practices. Qualifications • 5+ years of business analyst, implementation, client/payer-side, or healthcare RCM software/technology experience. • 3+ years of healthcare eligibility and benefits experience across hospital and/or physician workflows. • Strong knowledge of healthcare EDI transactions and workflows, including 270/271, 276/277, 278, 837, and 835. • Understanding of payer connectivity models, including direct connections, clearinghouses, trading partners, AS2, SFTP, APIs, and FHIR-based integrations. • Research payer requirements, interpret companion guides, and translate requirements into connectivity solutions. • Experience analyzing healthcare transaction data, diagnosing connectivity issues, validating outcomes, and managing payer lists or transaction availability data. • Experienced with Microsoft 365, Salesforce, Atlassian Jira, reporting tools, and dashboards. • Experience with Experian Health platforms, similar healthcare technology solutions, Epic/Cerner, data analysis, automation, or AI-driven solutions. Additional Information Benefits/Perks: • Great compensation package and bonus plan • Core benefits including medical, dental, vision, and matching 401K • Flexible work environment, ability to work remote, hybrid or in-office • Flexible time off including volunteer time off, vacation, sick and 12-paid holidays • Explore all our exciting benefits here: https://yourexperianbenefits.com/cand-index.html Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. You will be also eligible for a variable pay opportunity.

About Experian

Experian is a global information services company that provides data and analytical tools to clients around the world. The company was founded in 1996 and is headquartered in Dublin, Ireland. Experian operates in four main business areas: Credit Services, Decision Analytics, Marketing Services, and Consumer Services. The company provides credit reporting services to businesses and consumers, helping them to make informed decisions about credit and financial risk. Experian also provides data and analytics to help businesses manage risk, prevent fraud, and improve their marketing efforts. The company has operations in 45 countries and serves clients in more than 100 countries.
Learn more about Experian
Size
51,493 employees
Industry
Founded
1980
NASDAQ

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