Senior Healthcare EDI Analyst (Remote)

Experian Group; United States; Remote; USD 100,000 - 175,000; Full time

Job summary

Experian is seeking an EDI Analyst II to manage the electronic exchange of healthcare information. This role focuses on troubleshooting EDI transactions, ensuring HIPAA compliance, and optimizing automation and AI technologies to support healthcare processes. The ideal candidate will have substantial experience in healthcare revenue cycle management and a solid foundation in EDI protocols and standards.

Benefits

Great compensation package and bonus plan

Core benefits including medical, dental, vision

Flexible work environment

Flexible time off including vacation and sick leave

Qualifications

• 5 years' experience as an EDI analyst or similar role.
• Knowledge of EDI protocols and standards.
• Proficiency in EDI mapping tools and data analytics.

Responsibilities

• Monitor and troubleshoot EDI transactions.
• Ensure compliance with HIPAA regulations.
• Collaborate with teams on EDI issues and optimizations.

Skills

EDI protocols

Healthcare transactions

Data analytics tools

Problem-solving

Education

5 years' experience in EDI analysis or related field

Tools

Salesforce

Atlassian JIRA

Microsoft 365

Job description

Job Posting - Salary Range: $100,649 - $174,459

Company Description

Experian is a global data and technology company, powering opportunities for people and businesses around the world. We help to redefine lending practices, uncover and prevent fraud, simplify healthcare, create digital marketing solutions, and gain deeper insights into the automotive market, all using our unique combination of data, analytics and software. We also assist millions of people to realise their financial goals and help them to save time and money.

We operate across a range of markets, from financial services to healthcare, automotive, agrifinance, insurance, and many more industry segments.

We invest in people and new advanced technologies to unlock the power of data and to innovate. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), we have a team of 23,300 people across 32 countries. Our corporate headquarters are in Dublin, Ireland. Learn more at experianplc.com.

Job Description

Reporting to Experian Health, the EDI Analyst II will manage and support the electronic exchange of healthcare information. Responsibilities include establishing connectivity to exchange transactions, monitoring and troubleshooting EDI transactions, ensuring compliance with HIPAA regulations, and collaborating with internal teams and external partners. You will optimize product solutions, supporting process improvements, and navigating automation and AI technologies.

You Will

• Monitor and troubleshoot EDI transactions to resolve errors promptly.
• Maintain and grow direct connections with product and technology teams.
• Collaborate with internal teams and external partners on EDI issues.
• Ensure EDI transactions comply with HIPAA regulations.
• Communicate EDI connectivity issues with stakeholders.
• Identify process improvement opportunities with IT, operations, and business teams.
• Strong knowledge of transaction sets (270/271, 276/277, 278, 837, 835) and Patient Estimates.
• Communicate with all partners regarding EDI, API, and web/screen capture connectivity issues.
• Develop and maintain EDI documentation, including companion guides, smart checklists, payer lists, and internal process documentation.
• Host external working sessions with trading partners, vendors, and clients.
• Provide training and support to internal teams on EDI processes and best practices.
• Support automation and AI technologies.
• Leverage internal relationships to resolve transaction issues.
  
  

Qualifications

• 5 years' experience as an EDI analyst, business analyst, implementation, or client/payer-side (payer or hospital/health system) experience in healthcare revenue cycle management software and technology required.
• Knowledge of EDI protocols and standards, specifically 27x and 83x healthcare transactions.
• Proficiency in EDI standards (X12, EDIFACT, HL7), EDI mapping tools, and related software applications· Experience with business processes and workflows related to healthcare reimbursement and patient access.
• Experience using Salesforce, Atlassian JIRA, Microsoft 365 applications, with great proficiency in excel (can perform complex functions) and other data analytics tools.
• Familiar with Agile methodologies, including scrum and Kanban.
  
  

Benefits/Perks

Additional Information

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays
• Explore all our exciting benefits here: https://yourexperianbenefits.com/cand-index.html
  
  

Our uniqueness is that we celebrate yours. Experian's culture and people are important differentiators. We take our people agenda very seriously and focus on what matters; DEI, work/life balance, development, authenticity, collaboration, wellness, reward & recognition, volunteering... the list goes on. Experian's people first approach is award-winning; World's Best Workplaces 2024 (Fortune Top 25), Great Place To Work in 24 countries, and Glassdoor Best Places to Work 2024 to name a few. Check out Experian Life on social or our Careers Site to understand why.

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. You will be also eligible for a variable pay opportunity.

Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. Innovation is an important part of Experian's DNA and practices, and our inclusive workforce allows everyone to succeed and bring their whole self to work. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Customer Service

• Industries

  Information Services

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