EDI Healthcare Analyst-NO C2C /MUST Live in PST
Johnson Service Group (JSG) is seeking an EDI Analyst- Eligibility & Enrollment.
Remote. Must live in Pacific, Mountain or Central time zones.
Work Schedule: Monday-Friday 8:00am- 5:00pm
Key Responsibilities:
Electronic Data Exchange
- Manage daily EDI operations, ensuring the proper handling and processing of eligibility and benefit transactions.
- Monitor, reconcile, and troubleshoot inbound and outbound EDI files, including 834 benefit enrollment files.
- Coordinate system upgrades, file transfers, and resolve EDI transaction issues efficiently.
- Collaborate with carriers, vendors, and internal teams to implement fixes and enhancements.
Business Process Improvement
- Continuously identify opportunities to improve data accuracy, system efficiency, and operational workflows.
- Develop and document Standard Operating Procedures (SOPs) to streamline EDI processes.
- Lead initiatives to implement process improvements, reducing risks and increasing productivity.
- Communicate key changes and updates effectively to all stakeholders.
Customer Support & Portal Management
- Oversee functionalities of customer-facing portals (WERC, PERC, OPIS, Health View) ensuring their reliable performance.
- Act as a point of contact for vendors and clients regarding portal and enrollment system issues.
- Assist with technical support requests, including account management, security settings, and testing activities.
- Collaborate across departments to facilitate new client integrations and enrollment testing.
Other Duties
- Promote a culture of curiosity, accountability, and collaboration to help meet organizational goals.
- Maintain a HIPAA-compliant workstation, ensuring the security and confidentiality of protected health information.
- Perform additional duties as assigned to support organizational success.
Qualifications:
- Bachelor’s degree in Management Information Systems (MIS), Computer Science, Healthcare Administration, or related field; or three (3) years of relevant experience.
- Solid experience working with healthcare EDI transactions, particularly within health benefits administration.
- Proficiency in EDI software, tools, and platforms, with strong understanding of data flow, mapping, and troubleshooting.
- Knowledge of HIPAA regulations, healthcare eligibility, and enrollment processes.
- Strong communication skills, capable of collaborating across technical and non-technical teams.
- Demonstrated project management skills, from planning to execution, with attention to detail.
- Ability to analyze and resolve complex technical issues efficiently.
Additional Benefits:
JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.