EDI Technical Analyst (Claims) - Hybrid

Harris Jones Staffing Recruiting Llc; Phoenix (AZ); Remote; USD 85,000 - 120,000; Full time

Job summary

Harris Jones Staffing Recruiting Llc is seeking an EDI Technical Analyst (Claims) to support, analyze, test, and maintain EDI transactions and data exchanges for healthcare claims operations. You will collaborate with business and technical teams to troubleshoot production issues and develop mappings and documentation.

The ideal candidate combines strong EDI and SQL skills with healthcare systems knowledge, including experience supporting payer platforms like QNXT.

Qualifications

• EDI expertise with healthcare data exchanges.
• Experience with payer data formats and transformations.
• Strong SQL and data validation skills.

Responsibilities

• Production Support: resolve EDI production issues and participate in on-call rotations.
• Data Analysis & Mapping: analyze, map, and validate 270/271, 834, 835, 837 transactions.
• SQL & Monitoring: write SQL queries and monitor system performance with Splunk, App Insights.
• Testing & Documentation: create test plans, document results, and develop mapping docs.
• Integrations: support API integrations and ETL processes while building dashboards.
• Compliance: maintain HIPAA and EDI standards compliance.

Skills

EDI expertise

SQL proficiency

Data analysis

Healthcare payer tools

Communication skills

Tools

SQL Server

Splunk

App Insights

SOAP UI

Postman

ETL tools

Job description

HJ Staffing is seeking an EDI Technical Analyst (Claims) to support, analyze, test, and maintain EDI transactions, integrations, and data exchange processes for healthcare claims operations. In this role, you will partner with business and technical teams to troubleshoot production issues, develop technical documentation, create data mappings, and ensure successful data exchange between trading partners.

The ideal candidate combines strong analytical skills, EDI expertise, SQL proficiency, healthcare systems knowledge, and direct experience supporting payer platforms like QNXT to drive operational efficiency and data integrity.

Vital Requirements (Please Read Before Applying)

• Work Location: Must currently reside in Arizona and be able to commute to the Phoenix office (85021) at least one day per week.
• Work Authorization: Must be a US Citizen or Green Card holder. We cannot provide sponsorship now or in the future for this temp-to-hire role.
• Platform Experience: Direct, hands-on experience with the QNXT platform is strongly preferred and must be clearly listed on your resume.

What You Will Do

• Production Support: Support, troubleshoot, and resolve EDI production issues related to claims and trading partner transactions; participate in on-call support rotations.
• Data Analysis & Mapping: Analyze, map, and validate healthcare data exchanges including 270/271, 834, 835, and 837 transactions.
• SQL & Monitoring: Write and maintain SQL queries for production support, reporting, testing, and data validation. Utilize Splunk, App Insights, SOAP UI, and Postman to monitor and validate system performance.
• Testing & Documentation: Create and execute test plans, process test files, document results, and resolve defects. Develop technical specifications, mapping documents, and process flows.
• Integrations: Support API integrations, ETL processes, and enterprise data exchange initiatives while developing dashboards to monitor data quality.
• Compliance: Maintain strict compliance with HIPAA requirements and healthcare EDI standards including TR3, CAQH CORE, and Blue Exchange guidelines.

What You Will Bring

Required Experience

• 3 years of experience in computer technology and/or information systems.
• 2 years of experience in data analysis, data management and integration, data extraction, and reporting.
• 2 years of healthcare EDI experience.
• Hands-on experience with 270/271, 834, 835, and 837 EDI transactions.
• Recent, hands-on QNXT experience within a healthcare payer environment is strongly preferred.
• Hands-on experience with Microsoft SQL Server and writing SQL queries for production support, testing, troubleshooting, and reporting.
• Experience with data mapping, flat-file analysis, EDI file testing, and production support.

QNXT and Microsoft SQL Server is a must.

Work Authorization: Candidates must be U.S. citizens or Green Card holders. Sponsorship is unavailable because this is a 6-month temporary-to-hire position.

Location: This position is fully remote. However, candidates cannot reside in Alaska, California, Delaware, Hawaii, Kentucky, Maine, Massachusetts, Mississippi, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Puerto Rico, Washington, D.C., or Wyoming.

You Will Be Successful If:

• You can quickly identify, troubleshoot, and resolve complex data and integration issues.
• You confidently work with large datasets and translate complex business requirements into technical solutions.
• You thrive in a fast-paced environment with competing priorities and deadlines.
• You demonstrate strong communication skills and can easily explain technical concepts to non-technical business stakeholders.