Senior Billing EDI Analyst

Labcorp•Burlington, NC

1d•Hybrid

About The Position

Labcorp is seeking a Senior Billing EDI Analyst located in Burlington, NC or Durham, NC. This hybrid position offers a balanced schedule of three in-office workdays at our Burlington or Durham, NC locations and two remote workdays per week, supporting both collaboration and flexibility. The Senior Billing EDI Analyst serves as an experienced individual contributor responsible for managing complex healthcare EDI operations, resolving escalated transaction-related issues, and supporting strategic revenue cycle initiatives. This role reviews and analyzes healthcare EDI transactions, investigates transaction failures, performs root cause analysis, and leads testing and validation efforts related to payer onboarding, system enhancements, and EDI implementations. The position partners with payers, vendors, clearinghouses, IT teams, billing operations, and revenue cycle stakeholders to improve transaction accuracy, optimize operational processes, and promote successful EDI processing across the organization. As a subject matter resource, the Senior Billing EDI Analyst supports team development, process standardization, and ongoing EDI enhancement initiatives.

Requirements

Bachelor's degree with 5 or more years of direct healthcare analytical experience analyzing operational data, transaction data, reporting outputs, or business process performance metrics within a healthcare environment. AND 3 or more years of direct experience supporting healthcare billing EDI processes, transactions, implementations or operations OR
Associate’s degree with 7 or more years of direct healthcare analytical experience analyzing operational data, transaction data, reporting outputs, or business process performance metrics within a healthcare environment. AND 5 or more years of direct experience supporting healthcare billing EDI processes, transactions, implementations or operations OR
High School Diploma with 9 or more years of direct healthcare analytical experience analyzing operational data, transaction data, reporting outputs, or business process performance metrics within a healthcare environment. AND 7 or more years of direct experience supporting healthcare billing EDI processes, transactions, implementations or operations.
Demonstrate effective verbal and written communication when interacting with business partners, vendors, payers, clearinghouses, and internal stakeholders.
Collaborate with IT, billing, operations, revenue cycle, compliance, and vendor teams to resolve issues and support strategic initiatives.
Prioritize multiple concurrent assignments while meeting established service levels and project deadlines.
Apply analytical problem-solving approaches to investigate transaction exceptions, identify trends, and support operational improvements.
Provide guidance and operational support to team members regarding EDI processes, workflows, and troubleshooting methodologies.
Maintain attention to detail when reviewing transaction data, testing results, operational metrics, system outputs, and process documentation.
Support continuous improvement initiatives that enhance transaction accuracy, operational efficiency, and stakeholder satisfaction.

Nice To Haves

Associate degree or higher in Health Information Management, Healthcare Administration, Information Systems, Business Administration, Computer Science, or healthcare-related field.
3 or more years of experience supporting healthcare EDI transaction processing in a healthcare provider, payer, laboratory, revenue cycle management, or healthcare technology environment.
3 or more years of experience working with HIPAA X12 transactions including claims (837), remittance advice (835), eligibility (270/271), claim status (276/277), and acknowledgment transactions (999/277CA).
2 or more years of experience performing root cause analysis for EDI transaction failures, claim rejections, payment exceptions, eligibility issues, or transaction processing errors.
2 or more years of experience leading testing and validation activities for EDI implementations, payer onboarding initiatives, platform upgrades, payer changes, or system enhancements.
2 or more years of experience supporting payer integrations, clearinghouse integrations, revenue cycle optimization projects, or EDI enhancement initiatives.
1 or more years of experience mentoring team members on EDI operations, transaction troubleshooting, healthcare claims workflows, or issue resolution processes.
1 or more years of experience using SQL, business intelligence tools, healthcare analytics platforms, reporting tools, or data visualization solutions.

Responsibilities

Review, monitor, and analyze healthcare EDI transactions to ensure timely and accurate processing.
Investigate and resolve complex EDI transmission, mapping, eligibility, claim status, remittance, and payment-related issues.
Perform root cause analysis and implement corrective actions for recurring transaction failures and processing exceptions.
Serve as a primary escalation point for EDI-related operational issues and inquiries.
Coordinate issue resolution activities with payers, vendors, clearinghouses, IT teams, billing operations, and revenue cycle stakeholders.
Conduct data analysis, validation, and reconciliation activities using reporting and analytics tools.
Monitor, track, and report EDI operational performance metrics and exception trends.
Identify transaction processing inefficiencies and recommend workflow improvements to increase transaction accuracy and operational effectiveness.
Support revenue cycle optimization initiatives through analysis of EDI transaction performance and exception data.
Lead testing and validation activities for EDI implementations, payer onboarding, payer changes, system enhancements, and platform upgrades.
Create and maintain standard operating procedures (SOPs), workflows, process documentation, and training materials.
Support payer integrations, clearinghouse integrations, EDI enhancement initiatives, and revenue cycle projects.
Provide project updates, testing results, and operational reporting to leadership and stakeholders.
Mentor EDI Analyst I team members on transaction troubleshooting, issue resolution processes, and healthcare EDI workflows.
Provide subject matter expertise for complex transaction processing, issue investigation, and operational support activities.