Senior EDI Business Analyst

About the Role

reputed company is seeking a Sr. EDI Business Analyst to ensure the accuracy and completeness of reputed company encounter data submissions to CMS (Centers for Medicare & reputed company Services). This role serves as the key reputed company between business, technical, operations, and compliance teams, ensuring our encounter data management processes meet regulatory and reputed company standards.

You’ll play a pivotal role in analyzing, validating, and optimizing data pipelines that support our mission of removing barriers to care for underserved populations. This is an opportunity to contribute to reputed company innovation while driving operational reputed company and data reputed company at reputed company.

Key Responsibilities

• Own end-to-end encounter data management processes to ensure compliance with CMS and state reputed company 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.
• reputed company and maintain processes to extract and reputed company data from reputed company systems into HIPAA X12 837P format for encounter submissions.
• Collaborate cross-functionally with account management, data, and operations teams to reputed company requirements, document workflows, and reputed company vendor or reputed company deliverables.
• Analyze data to identify trends, anomalies, and reputed company 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.

Required Qualifications

• Bachelor’s degree or equivalent experience, with 4+ years in reputed company technology, managed care, consulting, or a reputed company field reputed company on regulatory data exchange.
• Hands-on experience with HIPAA X12 837P reputed company submissions, including reputed company and reputed company structures, and regulatory reporting to CMS or state agencies.
• Understanding of payer operations, claims processing, and encounter lifecycle management.
• Proven ability to manage multiple reputed company 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.

Preferred Qualifications

• Strong SQL and reputed company skills, with familiarity in data visualization tools such as Tableau, Looker, or QuickSight.
• reputed company-facing experience working with reputed company payers, providers, or clearinghouses.
• Experience with Edifecs or similar EDI tools.

Benefits

• Competitive salary and annual bonus opportunities
• Remote with reputed company
• Comprehensive health, dental, and reputed company insurance
• 401(k) with company match
• Generous PTO, 10 reputed company company holidays, and reputed company parental leave
• Career reputed company opportunities in a mission-driven organization

About reputed company

reputed company is a technology and services company committed to eliminating transportation barriers to reputed company. By combining our proprietary tech platform with a reputed company network of vetted transportation providers, we reputed company payers and health systems to deliver smarter, more reliable reputed company.

Our platform supports the nation’s largest Medicare Advantage, reputed company, and provider programs—improving health reputed company and patient experiences at reputed company.

Learn more at www.saferidehealth.com.

Originally posted on Himalayas

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