Healthcare EDI Implementation Analyst/Specialist

The EDI Implementation Analyst will coordinate and support the full lifecycle of healthcare EDI implementations, from requirements gathering and data mapping through testing, deployment, and post-production stabilization. Reporting to the EDI Director, this role will partner with clients, health plans, vendors, and internal technical and operational teams to translate business requirements into accurate, scalable file solutions. The EDI Implementation Analyst will analyze enrollment and claims data, validate file configurations and results, manage implementation milestones and risks, and serve as a subject-matter resource to promote accurate, timely, and compliant data exchange.

Responsibilities

• Lead assigned EDI implementations from intake through post-production stabilization, maintaining requirements, milestones, dependencies, risks, and status updates
• Gather and document business, technical, and operational requirements with clients, health plans, vendors, and internal stakeholders
• Analyze companion guides, file layouts, and source data to define mappings, validations, transformations, and processing rules
• Coordinate file configuration and development activities with programming and technical teams, clarifying requirements and resolving implementation questions
• Create test plans, produce and validate test files, reconcile results, document defects, and confirm that acceptance criteria are met
• Facilitate client and partner testing, communicate findings, track issue resolution, and obtain implementation approvals
• Prepare implementation readiness and go-live documentation, coordinate production deployment, and monitor initial production file cycles
• Perform production data reconciliation and root-cause analysis to resolve enrollment, claims, and file-transfer discrepancies
• Maintain implementation documentation, mapping specifications, decision logs, standard operating procedures, and handoff materials
• Identify opportunities to standardize implementation practices, strengthen controls, and improve data quality and delivery timeliness
• Provide implementation guidance and knowledge transfer to enrollment, claims, operations, and support teams
• Support team coverage and complete other implementation projects as assigned by management

Requirements:

• Three to four years of experience supporting healthcare EDI implementations, integrations, or production operations
• Working knowledge of HIPAA X12 transactions, with experience in enrollment and claims data preferred
• Experience gathering requirements, interpreting companion guides and file layouts, and documenting mapping and processing rules
• Demonstrated ability to develop test scenarios, validate files, reconcile data, document defects, and perform root-cause analysis
• Strong project coordination, organization, and communication skills, including the ability to manage multiple implementations and stakeholder priorities
• Familiarity with secure file transfer, ETL concepts, SQL or data-query tools, and development environments such as Visual Studio
• Self-starter with strong attention to detail and the ability to resolve complex implementation and data issues with minimal direction

Benefits

After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:

• Fantastic medical, dental, and vision insurance*
• Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
• Company provided Basic Life and AD&D
• Company paid Short-Term and Long-Term Disability**
• Flexible Spending Accounts*
• 401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)
• 10+ paid holidays
• Fully Paid half day Summer Fridays
• Generous paid vacation and sick time
• Annual Paid Volunteer Day
• Annual Tuition Reimbursement
• Annual Health and Wellness Reimbursement
• Lots of fun company events
• 60 day waiting period

**90 day waiting period