EDI Analyst -X12 835 files

Zelis; Missouri; Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company in healthcare claim lifecycle solutions is hiring EDI Analysts to support their growth strategy. The role involves reviewing EDI files, troubleshooting issues, and facilitating client interactions. Candidates should have robust EDI experience and thrive under pressure.

Qualifications

• 3+ years of EDI experience, with 1 year in healthcare.
• Experience in technical solution guidance & design.
• Ability to create and lead client presentations.

Responsibilities

• Using tools to review X12 835 files for issues.
• Supporting client implementation activities and generating 835 files.
• Participating in user acceptance testing.

Skills

Problem Solving

Critical Thinking

Communication

Tools

SQL Management Studio

Advanced Test Editors

Job description

Zelis is pursuing an aggressive organic and non-organic growth strategy focused on providing superior healthcare claim lifecycle solutions to payors, providers, and individuals from pre-payment through payment. As the company executes its growth strategy, Zelis is currently hiring EDI Analysts. The position will report to an EDI Manager and will work closely with managers and various team members.

Hiring remote at these locations:

• Morristown, NJ
• Atlanta, GA
• St Louis, MO
• St Pete, FL
• Plano, TX

Responsibilities include:

• Using advanced test editors and other technology tools to review X12 835 files for issues, including balance, structure, syntactical, data type, and content errors; developing and executing strategies to resolve them.
• Troubleshooting by querying the database using SQL Management Studio to review stored values and manually reviewing data files sent to Zelis by Payer clients.
• Supporting Payer and Provider client implementation activities by generating 835 files, reviewing content, and presenting findings to clients.
• Responding to inquiries regarding 835 issues, claims, payments, and clearinghouse activities.
• Interacting with other departments on communication issues related to customer and third-party vendor connectivity.
• Participating in user acceptance testing to approve items for release.
• Communicating with vendor contacts to identify file issues and disseminate resolutions to maintain compliance with HIPAA and Zelis data security standards.
• Supporting multiple client projects simultaneously and ensuring proper follow-up and completion.
• Working under pressure with multiple deadlines.
• Handling complex assignments requiring judgment, critical thinking, and initiative to accomplish objectives.

Minimum requirements:

• 3+ years of EDI experience, including 1 year in healthcare.
• Experience in technical solution guidance & design, including user acceptance testing.
• Ability to create, lead, and facilitate presentations to operations teams, stakeholders, and clients.

Preferred qualifications:

• Experience with EDI files (fixed length, delimited, X12, and/or EDI 835) and adjudication systems.
• Knowledge of SQL.
• Experience with advanced test editors or similar technology tools.
• Provider billing and claims payment experience is helpful.