Business Analyst – Eligibility (EDI)

ZipStaff Inc.; Boston (MA); Remote; USD 83,000 - 124,000; Part time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

401(k) + 401(k) matching

Paid time off

Referral Program

Job summary

ZipStaff Inc. seeks an experienced Business Analyst specializing in Electronic Data Interchange (EDI) to drive key project deliverables for a leading healthcare organization.

This remote-leaning role focuses on implementing 834 and proprietary eligibility, COB, and group files for various health plans. The analyst will independently lead end-to-end frameworks for processing eligibility exchanges, facilitate stakeholder discussions, and produce comprehensive documentation.

Qualifications

• Bachelor's Degree required.
• Expertise in Electronic Data Interchange (EDI).
• Experience implementing 834 and proprietary eligibility, COB, and group files for health plans.
• Strong experience developing and executing end-to-end test scenarios.

Responsibilities

• Lead design and implementation of end-to-end EDI eligibility frameworks.
• Facilitate discussions with plans and stakeholders to clarify requirements and review UAT.
• Create comprehensive documentation of business rules, processes, and technical specs.
• Conduct multiple rounds of end-to-end testing with strong testing experience.

Skills

EDI

Healthcare domain

UAT testing

Stakeholder facilitation

Education

Bachelor's Degree

Job description

Job Title: Business Analyst - Eligibility (EDI)

Location: Remote (Boston, MA base; Washington, DC on-site if required)

Employment Type: Contract (W2 through ZipStaff - No C2C or 1099)

About the Opportunity

ZipStaff is seeking an experienced Business Analyst specializing in Electronic Data Interchange (EDI) to drive key project deliverables for a leading healthcare organization.

This role focuses on implementing 834 and proprietary eligibility, COB, and group files for various health plans. The analyst will independently lead the design and implementation of end-to-end frameworks for processing eligibility exchanges, facilitate stakeholder discussions, create comprehensive documentation, and conduct rigorous end-to-end testing. This is a short-term contract assignment (through 12/31/2026) supporting a pre-identified vendor-to-W2 conversion opportunity. Work mode is primarily remote with a Boston, MA base worksite.

What You'll Do:

• Be a self-starter with the ability to work independently and with minimal oversight.
• Quickly develop a comprehensive understanding of the business rules, core platforms, and applications for the data used in EDI exchanges.
• Lead the design and implementation of innovative end-to-end frameworks for processing eligibility exchanges, ensuring they meet both business needs and industry standards.
• Facilitate and lead discussions with plans and other stakeholders to identify and clarify requirements, review UAT test cases, and ensure alignment on project objectives and deliverables.
• Develop comprehensive documentation outlining business rules, process flows, and technical specifications.
• Conduct multiple rounds of end-to-end testing with strong prior experience in developing and performing test scenarios.

Required Qualifications:

• Bachelor's Degree required.
• Expertise in Electronic Data Interchange (EDI).
• Experience implementing 834 and proprietary eligibility, COB, and group files for health plans.
• Strong prior experience in developing and performing test scenarios for end-to-end testing.
• Ability to work independently, facilitate stakeholder discussions, and produce clear documentation.
• Ability to work primarily remote (Boston, MA base worksite).

Preferred Qualifications:

• Prior experience supporting eligibility exchanges or related EDI processes in a healthcare payer environment.
• Hands-on experience with health plan eligibility, COB, and group file implementations.
• Track record of leading requirements discussions and UAT reviews with health plan stakeholders.
• Experience producing process flows, business rules documentation, and technical specifications for EDI frameworks.

Benefits:

• Health Insurance.
• Dental Insurance.
• Vision Insurance.
• 401(k) + 401(k) matching.
• Paid time off.
• Referral Program.