Healthcare EDI Analyst (Remote)

As the Healthcare EDI Business Analyst, you will manage electronic data interchange (EDI) processes and ensure accurate healthcare insurance coverage verification and maintenance. You'll report to Experian Health and manage new product development and operational efficiencies, by streamlining data exchange between internal systems and external partners, and by ensuring compliance with insurance policies and regulatory requirements. EDI Responsibilities: Monitor, troubleshoot, and maintain EDI transactions (e.g., 837, 835, 270/271, 276/277). Collaborate with IT and external vendors to resolve EDI transmission issues. Ensure timely and accurate data exchange between systems and trading partners. Develop and maintain documentation for EDI processes and workflows. Analyze EDI data for discrepancies and implement corrective actions. Insurance Discovery Responsibilities: Assist in the design and management of insurance coverage verification and insurance discovery technology using automated tools and manual processes. Maintain accurate insurance information in internal systems. Work with payers to resolve coverage issues and discrepancies. Assist in the development of policies and procedures related to insurance verification. Support audits and compliance initiatives related to insurance coverage. Cross-Functional Collaboration: Partner with Revenue Cycle, IT, and Compliance teams to ensure data integrity and operational alignment. Provide training and support to staff on EDI and insurance coverage processes.