EDI Analyst

Zelis • St. Louis, MO

7d • $65,000 - $82,650 • Hybrid

About The Position

As part of our continued growth, Zelis is seeking an experienced EDI Analyst II to support and optimize healthcare EDI integrations with a primary focus on ANSI X12 5010 835 Electronic Remittance Advice (ERA) transactions. In this role, you will troubleshoot complex EDI issues, improve integration processes through automation and AI-enabled tools, and ensure the accuracy, integrity, and compliance of healthcare payment data while collaborating with cross-functional teams and external partners.

Requirements

• Bachelor's degree in Information Systems, Healthcare Administration, Computer Science, or a related field, or equivalent experience.
• 5–7+ years of healthcare EDI experience, including 3–5+ years supporting HIPAA ANSI X12 835 transactions; experience with 837, 834, and 270/271 is a plus.
• Strong understanding of the healthcare claims lifecycle, payment processing, provider payment posting, and reconciliation.
• Experience with EDI validation tools (Edifecs, Crystal Validation), ANSI X12 standards, data mapping, and healthcare integration processes.
• Advanced SQL and data analysis skills; Microsoft SQL Server experience preferred.
• Proficiency with Microsoft Teams, Word, Excel, Notepad++, and AI tools such as ChatGPT; Jira, C#, or API experience is a plus.
• Excellent analytical, communication, troubleshooting, and problem-solving skills, with the ability to mentor junior analysts and collaborate across technical, operational, and client-facing teams.

Nice To Haves

• experience with 837, 834, and 270/271 is a plus
• Microsoft SQL Server experience preferred
• Jira, C#, or API experience is a plus

Responsibilities

• Analyze and troubleshoot complex ANSI X12 5010 835 (ERA) transactions, identifying processing, formatting, balancing, and compliance issues.
• Perform root cause analysis, resolve EDI processing issues, and implement preventive solutions.
• Design and maintain EDI integration workflows, data mappings, technical documentation, and testing plans.
• Interpret payer and provider specifications to ensure compliance with HIPAA, ANSI X12, and trading partner requirements.
• Generate, validate, and review EDI files, communicating findings and recommendations to internal teams and clients.
• Serve as the technical point of contact for escalated 835 remittance, provider payment, and clearinghouse issues.
• Partner with internal teams, clients, vendors, and trading partners to resolve integration, connectivity, and workflow challenges.
• Leverage AI-enabled tools and automation to improve data quality, validation, reconciliation, and operational efficiency.
• Manage multiple priorities, document best practices, ensure HIPAA compliance, and identify process improvement opportunities.
• Mentor junior analysts and stay current with healthcare EDI standards, integration technologies, and AI advancements.

Benefits

• 401k plan with employer match
• flexible paid time off
• holidays
• parental leaves
• life and disability insurance
• health benefits including medical, dental, vision, and prescription drug coverage

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level