Senior Healthcare EDI Integration Analyst
RemoteUnited States or Fargo, North Dakota, United States
United States or Fargo, North Dakota, United StatesRemoteContractSenior Level
ContractSenior Level
Job Summary
Monitor inbound and outbound Healthcare EDI transactions, investigate production alerts, and resolve failed processes for Medicare and Medicaid environments using TIBCO BusinessConnect, BusinessWorks, and Foresight. Troubleshoot rejected files, validate 837 claims and 835, 270, 271, 276 transaction sets, and support claims reconciliation to ensure HIPAA compliance. Coordinate with internal teams and external vendors to address trading partner inquiries and maintain operational documentation. Evaluate AI tools for automated log analysis and workflow optimization within the first 180 days.
Required Qualifications
- Minimum 5 years of Healthcare EDI production support experience
- Hands-on experience with the latest versions of TIBCO BusinessConnect (BC)
- Hands-on experience with the latest versions of TIBCO BusinessWorks (BW)
- Hands-on experience with the latest version of TIBCO Foresight
- Strong experience supporting Healthcare HIPAA ANSI X12 transactions
- Required expertise supporting 837 Healthcare Claims transactions
- Experience supporting 835, 270, 271, and 276 transaction sets
- Medicare and Medicaid EDI processing experience
- Healthcare claims reconciliation experience
- Experience troubleshooting production EDI environments
- Ability to work independently with minimal supervision in a high-volume production environment
- Strong analytical and problem-solving skills
- Excellent written and verbal communication skills
Desired Qualifications
- Experience supporting enterprise Healthcare integration environments
- Experience working directly with external trading partners and vendors
- Knowledge of Healthcare claims adjudication workflows
- SQL or scripting experience for production support and analysis
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