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TEKsystems is seeking an EDI Operations Specialist to support enrollment, claims, financial, and eligibility transactions using ANSI X12 HIPAA formats. You will interface with analysts, developers, project managers, and trading partners to manage EDI transactions and resolve issues.
Responsibilities include EDI setup, mapping, monitoring, documentation, and post-production support. The role requires strong SQL skills and experience in healthcare enrollment/claims systems, with remote work
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.
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.
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
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This is a Contract position based out of Grand Rapids, MI.
The pay range for this position is $50.00 - $65.00/hr.
Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job‑related factors.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
This is a fully remote position.
This position is anticipated to close on Sep 26, 2026.
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full‑Stack Technology Services, Talent Services, and real‑world application, we work with progressive leaders to drive change. That’s the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full‑stack capabilities and speed. We’re strategic thinkers, hands‑on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.