[Remote] Healthcare EDI Analyst - Payer Connectivity (Remote)
Note: The job is a remote job and is open to candidates in USA. Experian is a global data and technology company, and they are seeking a Healthcare EDI Analyst - Payer Connectivity. The role involves establishing and optimizing payer connections to support electronic healthcare transactions, while acting as a subject matter expert and collaborating with various teams to enhance connectivity reliability and operational efficiency.
Responsibilities
- 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
Skills
- 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
Company Overview
Company H1B Sponsorship