EDI Business Analyst

Job#: 3036954 Job Description: Location: Pleasanton, California (Remote) Role Overview This position will serve as the Subject Matter Expert for the Individual Coverage Health Reimbursement Arrangement (ICRA) workflow. The role involves managing individual plan data to ensure smooth enrollment and coverage, partnering with internal and external teams to troubleshoot processes, and supporting the implementation of new channel partners. The ideal candidate will monitor incoming data to maintain accuracy and timeliness while responding to various inquiries related to member records and enrollment. Key Responsibilities • Act as the Subject Matter Expert for the ICRA workflow. • Manage individual plan data to ensure smooth enrollment and member coverage. • Partner with internal teams and external channel partners to troubleshoot and improve processes. • Assist in the implementation of new channel partners by working with IT and conducting testing. • Monitor incoming data via API or electronic files (e.g., 834/820) to ensure accuracy and timeliness. • Respond to inquiries regarding member records, enrollment issues, and partner onboarding. • Handle membership inquiries and the implementation and decommissioning of partners. • Ensure members have access to care by monitoring data accuracy and resolving issues. Required Qualifications Technical Skills: Proficiency with Microsoft Excel, Word, and PowerPoint is required. Work Environment The position is remote and candidates must be based in Colorado or California, working Pacific or Mountain Standard Time hours. We are an equal opportunity employer and welcome applications from all qualified candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Apex uses a virtual recruiter as part of the application process. Click here for more details. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Benefits Department at [email protected] or 804-523-8228. Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico. Everforth Apex uses a virtual recruiter as part of the application process. Click here for more details. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Everforth Apex and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at https://www.apexsystems.com/privacy-policy Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide. Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you require an accommodation under the Americans with Disabilities Act to participate in an interview with a virtual recruiter or to use our website for a search or application, please contact our Benefits Department at [email protected] or 804-523-8228. Please note that this contact information is strictly to be used for medical ADA accommodations and that no other inquiries will be answered. UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems. © 2026 Everforth, Inc. All rights reserved. Everforth Apex Systems is part of the Commercial Segment of Everforth, Inc. NYSE: EFOR 4400 Cox Road Suite 200 Glen Allen, Virginia 23060 Everforth Apex is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Benefits Department at [email protected] or 804-523-8228. (Do not submit resumes or solicit consultants to this email address). UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex.