Senior EDI & Eligibility Analyst - Remote

Liviniti; United States; Remote; USD 70,000 - 110,000; Full time

Benefits offered by this job

Disability & Life insurance

Employee Assistance Program

Remote work options

Paid Time Off

Development plans & reviews

Retirement plan with company match

Job summary

Liviniti is seeking an experienced EDI/Eligibility Analyst III to join our remote team in the United States. This senior role drives complex eligibility work, ensuring data integrity across multiple systems and collaborating with clients, vendors, and internal teams.

You'll optimize eligibility workflows, support testing and production, and maintain documentation while upholding HIPAA and security standards. 5+ years in eligibility/EDI within PBM or health plans is preferred.

Qualifications

• Bachelor’s degree or equivalent experience.
• 5+ years of eligibility, EDI, or healthcare operations experience.
• PBM or health plan experience strongly preferred.
• Experience supporting production EDI and Eligibility environments.

Responsibilities

• Execute and support complex eligibility work within established ownership.
• Serve as escalation support and quality backstop for eligibility accuracy.
• Test, monitor, issue resolution, and escalation for eligibility issues.
• Analyze and resolve complex eligibility issues impacting claims, accumulators, and member coverage.
• Identify opportunities for automation and process improvement within eligibility workflows.

Skills

EDI expertise

Analytical skills

Independence

Decision making

Communication

Multitasking

Eligibility impact

Education

Bachelor’s degree or equivalent experience

Tools

SQL

Excel

ETL tools

Zendesk

JIRA

Azure DevOps

Snowflake

AWS

Azure

Job description

Liviniti is seeking an experienced EDI/Eligibility Analyst III to join our remote team in the United States. This senior role drives complex eligibility work, ensuring data integrity across multiple systems and collaborating with clients, vendors, and internal teams.

You'll optimize eligibility workflows, support testing and production, and maintain documentation while upholding HIPAA and security standards. 5+ years in eligibility/EDI within PBM or health plans is preferred.