EDI Analyst

Apex Systems; Grand Rapids (MI); On-site; USD 65,000 - 90,000; Full time

Job summary

Apex Systems is seeking an EDI Analyst to join the EDI Operations team in Grand Rapids, MI. The role focuses on managing enrollment, claims, financial, and eligibility transactions using ANSI X12 HIPAA formats, interfacing with business analysts, developers, project managers, trading partners, and software vendors.

Candidates should have strong experience with 834 enrollment files, Facets, and SQL queries; associate degree required, bachelor’s preferred; 2+ years in EDI data analysis, mapping,

Qualifications

• Required Associate's Degree or equivalent
• Preferred Bachelor's Degree
• 2 years of relevant experience Analyzing EDI data to identify content and/or formatting issues Required
• 2 years of relevant experience Using SQL queries to retrieve and/or display data Required
• 2 years of relevant experience Reading/analyzing/formatting/translating EDI data Required
• 2 years of relevant experience Implementing EDI setup and mapping Required
• 2 years of relevant experience Experience in the healthcare industry Preferred
• 2 years of relevant experience Experience with Facets software or a similar healthcare enrollment/claims management software system Preferred

Responsibilities

• Demonstrate knowledge of EDI standard formats and communicate complex data exchange concepts to internal and external parties. Interface professionally with various internal and external customers including Operations, Sales, Marketing, IS, and Trading Partners to understand and process work requests.
• Responsible for the implementation of electronic data interchange connections between Priority Health and external parties. Support ongoing implementations in post-production, including error identification/resolution, continuous improvement, and pro-active communication with the trading partners and providers to reduce/prevent errors.
• Verify and monitor EDI processes. Troubleshoot and resolve EDI related issues. Develop and maintain procedural documentation. Follow-up comprehensively with all stakeholders during issue remediation process to assure that delays are minimized and the process runs smoothly.
• Assist in defining application enhancements and upgrades.
• Perform application configuration, mapping, and monitoring of EDI transactions and processes.
• Support application testing effort by performing user acceptance testing (UAT) and assisting in defect resolution.
• Provide on-call support as necessary.

Skills

EDI data analysis

SQL queries

EDI data formatting

EDI setup

Healthcare experience

Education

Associate degree or equivalent

Bachelor's degree preferred

Tools

Facets software

Job description

Job Title: EDI Analyst

Job Start Date: 10/18/26

Job End Date: 1/29/27

Specific Skillset Requirements: Candidate must have robust knowledge and experience with 834 enrollment files and Facets.

Expenses allowed: no

Corewell Health Equipment to be Provided

Job Summary

Provides support for the EDI Operations department by interfacing with internal and external customers including business analysts, software developers, project managers, trading partners, and software vendors. This role is responsible for managing a range of EDI transactions including enrollment, claims, financial, and eligibility transactions using ANSI X12 HIPAA compliant formats. Provides technical support for the implementation of EDI connections with external parties; responds to inquiries related to EDI transactions; conducts analysis of EDI transactions; and provides issue resolution when necessary. Handles multiple enhancement requests and projects.

Essential Functions

• Demonstrate knowledge of EDI standard formats and communicate complex data exchange concepts to internal and external parties. Interface professionally with various internal and external customers including Operations, Sales, Marketing, IS, and Trading Partners to understand and process work requests.
• Responsible for the implementation of electronic data interchange connections between Priority Health and external parties. Support ongoing implementations in post-production, including error identification/resolution, continuous improvement, and pro-active communication with the trading partners and providers to reduce/prevent errors.
• Verify and monitor EDI processes. Troubleshoot and resolve EDI related issues. Develop and maintain procedural documentation. Follow-up comprehensively with all stakeholders during issue remediation process to assure that delays are minimized and the process runs smoothly.
• Assist in defining application enhancements and upgrades.
• Perform application configuration, mapping, and monitoring of EDI transactions and processes.
• Support application testing effort by performing user acceptance testing (UAT) and assisting in defect resolution.
• Provide on-call support as necessary.

Qualifications

• Required Associate's Degree or equivalent
• Preferred Bachelor's Degree
• 2 years of relevant experience Analyzing EDI data to identify content and/or formatting issues Required
• 2 years of relevant experience Using SQL queries to retrieve and/or display data Required
• 2 years of relevant experience Reading/analyzing/formatting/translating EDI data Required
• 2 years of relevant experience Implementing EDI setup and mapping Required
• 2 years of relevant experience Experience in the healthcare industry Preferred
• 2 years of relevant experience Experience with Facets software or a similar healthcare enrollment/claims management software system Preferred

Benefits Overview

• Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection.
• We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure.
• Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
• In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA.
• Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach.
• You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide.

Company Culture & Values

Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico.

Equal Opportunity Statement

Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

Accommodation Statement

If you require an accommodation under the Americans with Disabilities Act to participate in an interview with a virtual recruiter or to use our website for a search or application, please contact our Benefits Department at [email protected] or 804-523-8228. Please note that this contact information is strictly to be used for medical ADA accommodations and that no other inquiries will be answered.

Transparency Statement

UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems.