Analyst, Data Exchange (Medical, Dental & Vision)

Transformcap; Colorado; Hybrid; USD 81,000 - 121,000; Full time

Job summary

Judi Health in New York, NY is seeking a Data Exchange Analyst to ensure secure data exchange between Capital Rx – Judi Health and employers, providers, and TPAs. The role covers data integration, file transformation, error resolution, and ongoing monitoring of medical, dental, and vision data feeds.

The ideal candidate has strong experience with healthcare EDI (834/837/835), SQL, Excel, JSON, and HIPAA compliance, plus a collaborative, detail-oriented approach.

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• Knowledge of healthcare claim adjudication processes for medical, dental, and vision.
• Familiarity with EDI standards and tools such as EDIFECS.
• 2+ years of data analysis/integration/EDI experience in healthcare.
• Understanding of healthcare EDI transactions (e.g., 834, 837, 835).
• Strong analytical, problem-solving and communication skills.
• Familiarity with FTP/SFTP/FTPS and HIPAA compliance.

Responsibilities

• Design, develop, and maintain data mappings and transformations for healthcare files (837/835, 270/271, 278, 276/277, 999/TA1).
• Collaborate with internal teams and external partners to define data requirements.
• Onboard, test, and certify new connections and transaction sets.
• Implement data validation and error resolution processes.
• Monitor data exchange systems and troubleshoot issues.
• Document exchange processes, configurations, and troubleshooting steps.
• Identify opportunities to automate data exchange processes.

Skills

Data analysis

Data integration

EDI

SQL

Excel

JSON

HIPAA compliance

Analytical thinking

Communication

Problem solving

Education

Bachelor's degree in Computer Science/Information Systems/Healthcare Informatics

Tools

EDIFECS

FTP/SFTP/FTPS

Job description

About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health

Location: Hybrid 3 days a week in-office (NYC, Denver, CO or Charlotte, NC)

Position Summary

The Data Exchange Analyst is a crucial member of our Data Operations team, responsible for ensuring the accurate, efficient, and secure exchange of healthcare data between Capital Rx – JUDI Health and its various partners, including employers, providers, and other TPAs. This role focuses on the technical aspects of data integration, file transformation, error resolution, and ongoing monitoring of data feeds for medical, dental, and vision claims. The ideal candidate will possess a strong understanding of healthcare data formats, excellent analytical skills, and a commitment to data integrity and compliance.

Position Responsibilities

Data Integration & Mapping

• Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 – eligibility and responses, 278 – Prior Auth, 276/277 – claim status, 999/TA1 – file level acknowledgement as well as proprietary formats
• Collaborate with internal teams (e.g., Client Services, Claims, IT Development) and external partners (e.g., clearing houses or third-party administrators) to define data requirements and specifications
• Work with business teams and trading partners to onboard, test and certify new connections and transaction sets

Data Quality & Validation

• Develop and implement data validation rules and processes to ensure the accuracy, completeness, and consistency of exchanged data
• Proactively identify and resolve data discrepancies, errors, and rejections in a timely manner
• Perform root cause analysis for data issues and implement preventative measures

Monitoring & Support

• Proactively monitoring system status and Data Exchange management data to quickly identify potential abnormalities that might impact quality and accuracy
• Provide technical support and troubleshooting for data exchange issues, working with internal and external stakeholders to resolve problems
• Document data exchange processes, configurations, and troubleshooting steps

Process Improvement & Automation

• Identify opportunities to optimize and automate data exchange processes, improving efficiency and reducing manual effort
• Stay current with industry best practices, new technologies, and regulatory requirements related to healthcare data exchange

Reporting & Analysis

• Generate reports on data exchange performance, error rates, and key metrics
• Analyze data trends to identify potential issues or areas for improvement
• Analyze data trends to identify potential issues or areas for improvement
• Participate in projects with Data Exchange impacts including vendor changes, client migrations, and client add-on requests
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Required Qualifications

• Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or a related field. Equivalent work experience may be considered
• Knowledge of healthcare claim adjudication processes for medical, dental, and vision
• Strong knowledge and familiarity with EDI SNIP validations and one of the most widely used tools in the healthcare industry (e.g., EDIFECS)
• 2+ years of experience in data analysis, data integration, or EDI (Electronic Data Interchange) specifically within the healthcare industry
• Strong understanding of healthcare EDI transactions (e.g., 834 Enrollment, 837 Professional/Institutional/Dental Claims, 835 Remittance Advice)
• Excellent analytical, problem-solving, and critical thinking skills
• Familiarity with various file transfer protocols (FTP, SFTP, FTPS)
• Understanding of HIPAA compliance and other relevant healthcare regulations
• Strong attention to detail and a commitment to data accuracy
• Ability to analyze complex business problems to discover and resolve root causes
• Proficiency in SQL, Excel, JSON and other technical data skills preferred
• Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders
• Self-motivated and detail-oriented problem solver
• Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

New York, NY Salary Range $96,800—$121,000 USD

Denver, CO Salary Range $88,800—$111,000 USD

Charlotte, NC Salary Range $80,800—$101,000 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.