EDI Analyst, Transaction Specialist

Job Description:

• Own functional EDI workflows, partner requirements, and data validation rules
• Interpret and troubleshoot transaction sets: 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA
• Analyze SNIP compliance, companion guides, and partner-specific validation rules
• Document mapping and logical requirements for new partners and integration changes
• Partner with business stakeholders on issue resolution and operational impact assessments
• Support audit and compliance reviews and maintain data-quality guardrails
• Collaborate with EDI Analysts, DevSecOps Engineers, cloud teams, and business teams
• Identify root causes of transaction errors and resolve mapping mismatches
• Troubleshoot payer or state-system rejections and middleware/API issues
• Query SQL databases and reconcile raw EDI with stored data

Requirements:

• Bachelor’s or master’s degree in computer science, engineering, or a related technical discipline required; equivalent practical experience considered
• Edifecs certification
• Minimum 8 years of Edifecs product experience in EDI, healthcare, or enterprise application operations
• Minimum 8 years EDI/HIPAA experience
• Strong understanding of payer/provider workflows
• Ability to interpret loops/segments/element-level errors
• Familiarity with Edifecs Transaction Management or equivalent tools
• Strong proficiency in X12 / HIPAA EDI transaction structure, rules, and field-level details for 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA
• Understanding of EDI X12 loop/segment/element interpretation, SNIP validations Levels 1–7, companion guide interpretation, and segment- or element-level error analysis
• Experience interpreting Edifecs XEngine validation results, processing rules, and transaction profiles
• Experience with SpecBuilder maps and implementation guides
• Ability to identify issues from Edifecs routes, profiles, or rulesets
• Ability to interpret Edifecs logs and error codes at the functional layer
• Proficiency identifying transaction-error root causes, resolving mapping mismatches, troubleshooting payer or state-system rejections, and reviewing parsed EDI structures in SQL databases
• Ability to understand inbound/outbound workflow architecture
• Experience with AS2, SFTP, and HTTPS flows
• Ability to validate data sent to and received from non-X12 partners
• Ability to identify issues introduced by middleware layers or APIs
• Ability to query SQL for transaction details
• Ability to validate payloads, timestamps, statuses, and error flags
• Ability to reconcile mismatches between raw EDI and stored data
• Ability to communicate technical architecture decisions and trade-offs to non-technical stakeholders
• Experience translating business reporting requirements into technical data models
• Experience with agile methodologies (Scrum, Kanban) and JIRA
• Strong documentation habits, including transaction flow documentation, error trend reports, escalations, SOPs, and partner reference guides
• US Citizenship required with the ability to obtain and maintain a Public Trust clearance