EDI Claims Implementation Expert

Veriipro; Latham (NY); On-site; USD 85,000 - 125,000; Full time

Job summary

Veriipro in New York seeks an experienced EDI Claims Implementation Specialist to support the end-to-end rollout and ongoing maintenance of EDI claims transactions. You will work with business stakeholders, IT, and external partners to ensure accurate claims processing and system integration.

The role focuses on 837/835 transactions, mapping, testing, and troubleshooting, with a strong emphasis on data validation and compliance with HIPAA standards.

Qualifications

• Must have experience implementing and supporting EDI claims transactions.
• Strong knowledge of EDI 837/835 and X12 standards.
• Experience with EDI mapping, testing, troubleshooting, and partner integrations.
• Understanding of claims processing workflows and data validation.
• Excellent analytical, problem-solving, and communication skills.

Responsibilities

• Implement and support EDI claims transactions, including 837 (Claims) and 835 (Payment/Remittance).
• Coordinate EDI onboarding, mapping, configuration, testing, and implementation with trading partners.
• Troubleshoot EDI transaction errors, claim rejections, and integration issues.
• Validate EDI files and ensure compliance with applicable transaction standards.
• Collaborate with business, IT, and external partners to resolve implementation issues.
• Develop implementation documentation, test scenarios, and status reports.
• Support production issues and continuous improvements in claims processing workflows.

Skills

EDI transactions

X12 standards

EDI mapping

Claims workflows

Analytical skills

Communication

Tools

EDI platforms

Trading partners

Clearinghouses

HIPAA rules

Job description

Veriipro in New York seeks an experienced EDI Claims Implementation Specialist to support the end-to-end rollout and ongoing maintenance of EDI claims transactions. You will work with business stakeholders, IT, and external partners to ensure accurate claims processing and system integration.

The role focuses on 837/835 transactions, mapping, testing, and troubleshooting, with a strong emphasis on data validation and compliance with HIPAA standards.