Healthcare EDI Analyst Payer Connectivity (Remote)

Experian


Job Location:

Costa Mesa, CA - USA

Monthly Salary: Not Disclosed
Posted on: 2 hours ago
Vacancies: 1 Vacancy

Department:

Customer Service

Job Summary

The EDI Analyst Payer Connectivity establishes maintains and optimizes payer and trading partner connections that support reliable electronic healthcare transactions. You will research payer requirements implements and validates connectivity solutions maintains accurate payer data and resolves transaction issues across supported workflows. You will be a subject matter expert and escalation point partnering with our teams and external partners to improve connectivity reliability scalability and operational efficiency.

Youll have opportunity to:

  • Research payer requirements and establish new direct or trading partner connectivity solutions.
  • Maintain payer connectivity data including payer IDs transaction availability connection type and status.
  • 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.

Qualifications :

  • 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/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.

Additional Information :

Benefits/Perks:

The EDI Analyst Payer Connectivity establishes maintains and optimizes payer and trading partner connections that support reliable electronic healthcare transactions. You will research payer requirements implements and validates connectivity solutions maintains accurate payer data and resolves tran...

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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 marketing solutions, and gain deeper insights into the automotive market, ... View more

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