Healthcare EDI Analyst - Payer Connectivity (Remote)

Experian • Costa Mesa, CA

1d • $89,865 - $155,767 • Remote

About The Position

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.

Requirements

• 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.

Nice To Haves

• Experience with Experian Health platforms, similar healthcare technology solutions, Epic/Cerner, data analysis, automation, or AI-driven solutions.

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.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed