EDI Analyst (Healthcare Industry)

EDI Analyst (Healthcare Industry) Department: Data Platform Reports To: Data Engineering Leader / Onshore Data Architect Status: Are you legally eligible to work where you live? We are not able to sponsor VISAs. Resume must be in English Location: Remote Engagement: Contract, Long Term, Full Time Position Overview We are seeking an ETL Operations Analyst to configure, monitor, and continuously improve inbound data feed pipelines supporting hospital claims billing and payment reconciliation for complex and commercial claims. This role analyzes and evaluates flat files received from health systems and physicians—including claims (837I/837P), remittance (835), claims status (277), claims inventory, and payment data—ensuring accurate and timely ingestion into downstream billing and collections workflows. The analyst serves as the primary ETL contact for internal and external stakeholders, recommends process improvements, and partners with Data Engineering to ensure implementations meet billing system and data quality requirements. Key Responsibilities • Analyze inbound flat files from health systems and physicians containing claims, payments, inventory, and reconciliation data; support ad hoc analysis of payment variance and reconciliation exceptions. • Evaluate file structure, completeness, and data quality to determine the appropriate ETL configuration and mapping approach. • Configure and maintain inbound pipelines for claims (837I/837P), remittance (835), claims status (277), and supplemental payer files. • Monitor daily ETL job execution across all active feeds; resolve failures, missing files, or data quality issues before they impact revenue collections or payment posting. • Serve as the primary ETL contact for internal teams and external payers; deliver timely status updates to keep billing operations, revenue cycle leadership, and technical stakeholders informed. • Recommend improvements to feed specifications, ETL processes, and claims intake workflows; partner with Data Engineering to validate implementations meet billing system and data quality requirements. Requirements and Qualifications • Associate’s degree in Computer Science, Information Technology, Data Science, or a related field; or equivalent experience. • 2+ years working with hospital and physician claims data; familiarity with UB-04, CMS-1500, inpatient/outpatient billing, and complex and commercial payer adjudication. • Experience with healthcare EDI (837I, 837P, 835, 277), claims inventory and payment flat files, and data sourced from Epic, MEDITECH, Cerner, and Athena systems. • 2+ years of SQL/T-SQL experience; working knowledge of file delivery processes including SFTP, PGP encryption, and monitoring ingestion status. • Detail-oriented analytical thinker; strong communicator with Jira proficiency and the ability to investigate discrepancies, resolve issues, and keep stakeholders informed. Special Considerations and Prerequisites • Practices and adheres to EnableComp’s Core Values, Vision, and Mission. • Maintains stable performance under pressure; handles stress in ways that preserve stakeholder relationships. • Exceptional analytical, conceptual, and problem-solving abilities. • Strong written and oral communication skills; able to present complex ideas clearly. • Able to prioritize and execute tasks effectively in a high-pressure environment. • Experience working in a team-oriented environment.