Note: The job is a remote job and is open to candidates in USA. w3r Consulting is seeking an experienced Healthcare EDI Systems Analyst to support the implementation and optimization of HIPAA-compliant EDI transactions across healthcare systems. The role requires hands-on experience with healthcare claims and strong knowledge of healthcare integration and revenue cycle processes.
Responsibilities
- Support the implementation, maintenance, troubleshooting, and optimization of HIPAA-compliant EDI transactions across healthcare systems
- Troubleshooting EDI transactions, claim errors, and production support issues
- Working with providers, payers, clearinghouses, or healthcare technology organizations
Skills
- 3+ years of Healthcare EDI experience
- Strong experience supporting HIPAA ANSI X12 transactions:
- 834 Enrollment
- 835 Remittance (ERA)
- 837 Professional/Institutional/Dental Claims
- 270/271 Eligibility
- 276/277 Claim Status
- 278 Prior Authorization
- 999 & TA1 Acknowledgments
- Experience troubleshooting EDI transactions, claim errors, and production support issues
- Knowledge of healthcare claims processing, revenue cycle management (RCM), and payer/provider workflows
- Experience working with providers, payers, clearinghouses, or healthcare technology organizations
- Strong SQL skills for data analysis and troubleshooting
- Experience with APIs, HL7, FHIR, XML, and JSON
- Experience with one or more EDI platforms such as IBM Sterling, Edifecs, Cleo, OpenText, Boomi, MuleSoft, TriZetto, or Oracle Integration Cloud
- Excellent analytical, communication, and problem-solving skills
- Experience supporting healthcare applications such as Epic, Cerner, Facets, QNXT, HealthEdge, Athenahealth, or Meditech
- Knowledge of Medicare, Medicaid, and CMS regulations
- Experience with cloud integration platforms (Azure, AWS, or Google Cloud)
- CPHIMS or Healthcare Informatics certification is a plus
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