Job Details

Sr. EDI Analyst
US/Remote
Job Summary
A Sr. EDI Analyst expert with 837 transaction experience in healthcare is
responsible for designing, implementing, and managing electronic data
interchange (EDI) transactionsparticularly the ANSI X12 837 health care claim
format, which is critical for submitting medical claims to payers
Duties & Responsibilities
 Analyze, design, and implement EDI solutions specifically for 837 transactions
related to healthcare claims, ensuring proper parsing and mapping
according to business and regulatory requirements.
 Monitor and troubleshoot EDI transactions, resolving errors promptly and
ensuring compliance with HIPAA and industry standards.
 Collaborate with technical, billing, and compliance teams, as well as
external trading partners, to facilitate seamless data exchanges and timely
claim submissions.
 Maintain comprehensive EDI documentation, including companion guides,
payer lists, and internal process workflows.
 Develop and conduct end-to-end testing of transactions, validating
technical specifications and business rules.
 Guide and mentor team members on mapping techniques, regulatory
updates (ANSI 4010 to 5010), and process improvements.
 Support onboarding of new trading partners, and ensure data integrity and
security across all EDI transactions.
 Stay updated on healthcare regulatory changes and adapt EDI processes
accordingly.
Requirements & Qualifications
 Deep expertise in EDI transaction sets, especially 837 (claims), along with related
formats like 835 (payments), 834 (enrollment), etc.
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 Proficiency in EDI mapping, transformation, and validation using industry-standard
tools and technologies.
 Strong analytical and troubleshooting skills with healthcare claims and encounter
data.
 Knowledge of HIPAA regulations, claim submission workflows, and healthcare
coding systems (ICD, CPT, HCPCS).
 Effective communication and collaboration skills to work with multidisciplinary
teams and external entities
Evaluation Criteria
 Data-driven and detail-oriented mindset.
 Strong communication and stakeholder engagement skills.
 Ability to manage multiple priorities and deliver quality results on time.
 Proactive in identifying data issues and proposing improvement solutions.
Physical Work Essentials: NA
Please send your resume and salary requirements to
careers@elevancesystems.com
Elevance Systems, Inc. is an equal opportunity employer, which prohibits
discrimination and harassment of any type and affords equal employment
opportunities to employees and applicants without regard to race, color,
religion, sex, sexual orientation, gender identity or expression, pregnancy, age,
national origin, disability status, genetic information, protected veteran status, or
any other characteristic protected by law.
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