EDI Technical Analyst (Claims)

Impresiv Health•Phoenix, AZ

15h•Remote

About The Position

Impresiv Health is seeking an EDI Technical Analyst to support a leading healthcare payer in maintaining, enhancing, and optimizing EDI solutions. This technical role requires experience with healthcare EDI transactions, QNXT, Microsoft SQL Server, data analysis, file testing, and production support within a healthcare environment. The ideal candidate will independently troubleshoot complex production issues, analyze system processes and data, develop technical documentation and mapping specifications, support testing and defect resolution, and partner with cross-functional teams to deliver reliable EDI integrations and data exchange solutions. Experience with HIPAA transactions, including 270/271, 834, 835, and 837, is required.

Requirements

High School Diploma or GED required.
At least one year of college-level coursework in system requirements design and interpretation and/or production systems support.
3+ years of experience in computer technology and/or information systems.
2+ years of experience in data analysis, data management and integration, data extraction, and reporting.
2+ years of EDI experience.
Hands-on experience with 270/271, 834, 835, and 837 EDI transactions.
Hands-on experience with QNXT.
Required technical experience with Microsoft SQL Server.
Intermediate proficiency with PC applications, spreadsheets, databases, flowcharting tools, and word-processing software.
Intermediate knowledge of data mapping techniques, data analysis tools, computer operating systems, Microsoft Office applications, Windows Server, and Microsoft SQL databases.

Nice To Haves

Experience with Splunk, Application Insights, API monitoring, and production support is preferred.
The technical assessment will test SQL knowledge.

Responsibilities

Track, research, analyze, and resolve production issues involving EDI transactions, flat files, applications, and related processes.
Develop business objectives, processing requirements, technical specifications, functional specifications, logic flows, and data mapping documents.
Analyze inbound and outbound files and map data between systems.
Write SQL queries to support production analysis, testing, troubleshooting, and reporting.
Use Splunk and Application Insights to review logging results and troubleshoot processing issues.
Create test data and test files, execute testing, analyze results, document outcomes, and log defects.
Support regression testing, root cause analysis, defect triage, traceability, and defect review meetings.
Conduct technical and data-focused research required to create and test Trading Partner files.
Apply Trading Partner requirements, including TR3, CORE CAQH, and Blue Exchange rules.
Partner with IT Infrastructure to develop and implement production monitoring for APIs, data loads, Trading Partner transactions, and other critical processes.
Participate in or lead projects by developing project plans, estimates, schedules, presentations, priority lists, and ad hoc reports.
At senior and lead levels, mentor team members, serve as a subject matter expert, lead complex technical initiatives, and support service-level agreement performance.