Support, troubleshoot, and resolve EDI production issues related to claims and trading partner transactions
Analyze, map, and validate healthcare data exchanges including 270/271, 834, 835, and 837 transactions
Develop technical specifications, mapping documents, process flows, and operational procedures
Write and maintain SQL queries for production support, reporting, testing, and data validation
Perform root cause analysis and collaborate with internal teams to resolve data and integration issues
Create and execute test plans, process test files, document results, and support defect resolution activities
Utilize tools such as Splunk, App Insights, SOAP UI, and Postman to monitor, troubleshoot, and validate system performance
Support API integrations, ETL processes, and enterprise data exchange initiatives
Develop dashboards, reports, and monitoring solutions to ensure data quality and transaction integrity
Participate in project planning, implementation activities, and continuous process improvement initiatives
Maintain compliance with HIPAA requirements and healthcare EDI standards including TR3, CAQH CORE, and Blue Exchange guidelines
Participate in on-call support rotations and production incident response activities

High School Diploma or GED required; Bachelor's degree in Computer Science, Information Systems, Business, or related field preferred
2+ years of EDI experience supporting healthcare transactions
Experience working with healthcare claims, enrollment, eligibility, or payment transactions (270/271, 834, 835, and 837 preferred)
Strong experience with QNXT is highly preferred
Experience supporting healthcare payer environments, claims processing systems, and trading partner integrations
Experience in data analysis, data management, integration, and reporting
Strong SQL query development and database analysis skills
Knowledge of healthcare EDI standards, HIPAA regulations, and data mapping methodologies
Experience with testing tools such as SOAP UI and Postman
Familiarity with monitoring and logging tools such as Splunk and App Insights
Understanding of API integrations, ETL processes, cloud platforms (AWS, Azure), and enterprise application environments
Knowledge of Edifecs EDI platform is a plus

Candidates must be US citizens or Green Card holders
No sponsorship is permitted as this is a temp-to-hire position
Hybrid Role
Candidates must currently reside in Arizona and be able to work onsite at one of the Arizona offices at least one day per week

EDI Technical Analyst – Claims

Key skills