Healthcare EDI Analyst – Payer Connectivity

🔥 25 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $89.9k - $155.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Experian

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1996

🤖 Artificial Intelligence

🤝 B2B

☁️ SaaS

Artificial Intelligence • B2B • SaaS

Experian is a global leader in digital experience, technology, and transformation. They partner with recognized brands to enhance customer understanding, innovate product strategies, and implement agile technology solutions. With a focus on delivering superior customer experiences through AI, cloud architecture, and project management, Experian helps businesses streamline their operations and achieve their objectives effectively.

📋 Description

• Establish, maintain, and optimize payer and trading partner connections that support reliable electronic healthcare transactions • Research payer requirements, implement and validate connectivity solutions, maintain accurate payer data, and resolve transaction issues across supported workflows • Be the subject matter expert and escalation point for payer connectivity, EDI, API, and web/screen capture issues • Partner with Product, Clearinghouse, Implementation, Engineering, Support, vendors, and trading partners to support setup, troubleshooting, and optimization • Document payer lists, workflows, requirements, research findings, issue resolutions, and reference materials in established systems • Validate and monitor new payer connections to ensure successful transaction exchange • Analyze reporting, dashboards, Salesforce cases, and Jira tickets to identify trends, risks, and improvement opportunities • Support process improvement, automation, and AI-driven projects that improve monitoring, data accuracy, and workflow efficiency • Provide guidance and training on payer connectivity processes and best practices.

🎯 Requirements

• 5+ years of business analyst, implementation, client/payer-side, or healthcare RCM software/technology experience • 3+ years of healthcare eligibility and benefits experience across hospital and/or physician workflows • Strong knowledge of healthcare EDI transactions and workflows, including 270/271, 276/277, 278, 837, and 835 • Understanding of payer connectivity models, including direct connections, clearinghouses, trading partners, AS2, SFTP, APIs, and FHIR-based integrations • Research payer requirements, interpret companion guides, and translate requirements into connectivity solutions • Experience analyzing healthcare transaction data, diagnosing connectivity issues, validating outcomes, and managing payer lists or transaction availability data • Experienced with Microsoft 365, Salesforce, Atlassian Jira, reporting tools, and dashboards • Experience with Experian Health platforms, similar healthcare technology solutions, Epic/Cerner, data analysis, automation, or AI-driven solutions.

🏖️ Benefits

• 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