Eligibility & EDI Data Analyst

Judi Health, LLC; New York (NY); Hybrid; USD 97,000 - 121,000; Full time

Job summary

Judi Health, LLC is seeking a skilled Eligibility Data Specialist to join our hybrid team in the New York area. You will participate in client implementations, discuss eligibility requirements, and coordinate data transfers with external partners to ensure clean, accurate enrollment data.

The role requires 1+ years in PBM or healthcare data exchange, strong SQL/Excel/JSON skills, and excellent communication to collaborate across internal and external stakeholders.

Qualifications

• 1+ years of experience in PBM, healthcare data exchange or eligibility
• Ability to map PBM concepts and data fields across systems to ensure data transfer accuracy
• Strong analytical thinking to identify root causes of complex problems
• Proficiency with SQL, Excel, JSON and related data tools preferred
• Excellent communication to collaborate with internal/external stakeholders
• Detail-oriented with ability to manage competing priorities in a dynamic environment

Responsibilities

• Attend new client implementation meetings with external partners to discuss eligibility requirements and protocols
• Recommend eligibility file formats to external partners and coordinate receipt and processing of eligibility data
• Act as a healthcare data SME on Eligibility guidelines and EDI protocols
• Coordinate eligibility issue identification and resolution with internal teams and external partners
• Identify and triage eligibility issues and support error resolution for data transfers
• Monitor system status and eligibility data to identify abnormalities affecting data quality
• Ensure issues/errors are resolved within operating standards and service levels
• Assist with validation of eligibility data integrity through audits and reconciliation
• Ensure accurate entry of group/plan structure determinations for benefits and enrollment
• Adhere to Judi Health Code of Conduct including reporting non-compliance

Skills

SQL

Excel

JSON

Data analysis

Communication

Tools

EDI protocols

Job description

Judi Health, LLC is seeking a skilled Eligibility Data Specialist to join our hybrid team in the New York area. You will participate in client implementations, discuss eligibility requirements, and coordinate data transfers with external partners to ensure clean, accurate enrollment data.

The role requires 1+ years in PBM or healthcare data exchange, strong SQL/Excel/JSON skills, and excellent communication to collaborate across internal and external stakeholders.