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Senior EDI Analyst, Healthcare Transactions
Manage healthcare EDI transaction workflows, validation, and partner integrations for SAIC’s mission technology services. Troubleshoot HIPAA transaction errors across payer and provider operations.
Apraksts
- Manage EDI workflows, partner requirements, and data validation rules.
- Interpret and troubleshoot 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA transaction sets.
- Review SNIP compliance, companion guides, and partner-specific validation rules.
- Document mappings and logic requirements for new partners and integration updates.
- Work with business stakeholders to resolve issues and assess operational impact.
- Support audits and compliance reviews while maintaining data quality controls.
- Coordinate with EDI analysts, DevSecOps engineers, cloud teams, and business teams.
- Find transaction error root causes and correct mapping mismatches.
- Investigate payer or state system rejections and middleware or API issues.
- Query SQL databases and reconcile raw EDI with stored records.
Prasības
- A bachelor’s or master’s degree in computer science, engineering, or a related technical field; equivalent practical experience may be considered.
- Edifecs certification.
- At least 8 years of Edifecs product experience in EDI, healthcare, or enterprise application operations.
- At least 8 years of EDI and HIPAA experience.
- Strong understanding of payer and provider workflows.
- Ability to interpret loop, segment, and element-level errors.
- Familiarity with Edifecs Transaction Management or equivalent tools.
- Strong command of X12 and HIPAA EDI structures, rules, and field details for 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA transactions.
- Understanding of X12 loop, segment, and element interpretation; SNIP validation Levels 1–7; companion guides; and segment- or element-level error analysis.
- Experience interpreting Edifecs XEngine validation results, processing rules, and transaction profiles.
- Experience with SpecBuilder maps and implementation guides.
- Ability to identify issues in Edifecs routes, profiles, or rulesets.
- Ability to interpret Edifecs logs and functional-layer error codes.
- Proficiency in finding transaction error root causes, resolving mapping mismatches, troubleshooting payer or state system rejections, and reviewing parsed EDI structures in SQL databases.
- Ability to understand inbound and outbound workflow architecture.
- Experience with AS2, SFTP, and HTTPS flows.
- Ability to validate data exchanged with non-X12 partners.
- Ability to identify issues introduced by middleware layers or APIs.
- Ability to query SQL for transaction details.
- Ability to validate payloads, timestamps, statuses, and error flags.
- Ability to reconcile discrepancies between raw EDI and stored data.
- Ability to explain technical architecture decisions and trade-offs to nontechnical stakeholders.
- Experience translating business reporting requirements into technical data models.
- Experience with Agile methods such as Scrum or Kanban and with JIRA.
- Strong documentation skills, including transaction flow documentation, error trend reports, escalations, standard operating procedures, and partner reference guides.
- U.S. citizenship and the ability to obtain and maintain a Public Trust clearance.