Senior EDI Business Analyst

SafeRide Health is a technology and services company committed to eliminating transportation barriers to healthcare. They are seeking a Senior EDI Business Analyst to ensure the accuracy and completeness of healthcare encounter data submissions to CMS, serving as a liaison between various teams to meet regulatory standards.

Responsibilities:

• Own end-to-end encounter data management processes to ensure compliance with CMS and state Medicaid guidelines
• Compile, analyze, and validate encounter submissions to ensure accuracy, completeness, and alignment with Service Level Agreements (SLAs)
• Support audit and regulatory reporting initiatives by developing and maintaining documentation and validation frameworks
• Develop and maintain processes to extract and transform data from source systems into HIPAA X12 837P format for encounter submissions
• Collaborate cross-functionally with account management, data, and operations teams to gather requirements, document workflows, and oversee vendor or client deliverables
• Analyze data to identify trends, anomalies, and root causes, providing actionable insights to optimize workflows and improve ETL efficiency
• Recommend and implement process improvements that enhance scalability, accuracy, and compliance across encounter data workflows

Requirements:

• Bachelor's degree or equivalent experience, with 4+ years in healthcare technology, managed care, consulting, or a related field focused on regulatory data exchange
• Hands-on experience with HIPAA X12 837P Medicaid submissions, including loop and segment structures, and regulatory reporting to CMS or state agencies
• Understanding of payer operations, claims processing, and encounter lifecycle management
• Proven ability to manage multiple projects independently, prioritize effectively, and meet tight deadlines
• Strong analytical, problem-solving, and communication skills
• Highly self-sufficient and detail-oriented, comfortable in a fast-paced, dynamic environment
• Strong SQL and Excel skills, with familiarity in data visualization tools such as Tableau, Looker, or QuickSight
• Client-facing experience working with healthcare payers, providers, or clearinghouses
• Experience with Edifecs or similar EDI tools