Senior Systems Analyst (EDI) at ANGARAI

College Park, Maryland, United States -

Full Time

Start Date

Immediate

Expiry Date

26 Sep, 26

Salary

0.0

Posted On

28 Jun, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

EDI Analysis, X12 Transaction Sets, SQL, Data Validation, Root Cause Analysis, Healthcare Eligibility Systems, EDI Companion Guides, Edifecs, WTX, Medicaid 8001 Processing, ACA Eligibility Rules, Technical Documentation, Problem Solving, Communication, Data Correction, System Analysis

Industry

Business Consulting and Services

Description

The Senior Systems Analyst (EDI) is responsible for providing Electronic Data Interchange (EDI) data analysis, transaction support, error resolution, and related services for large-scale healthcare or eligibility-based systems. This role works closely with technical, business, and testing teams to analyze, resolve, and transmit EDI transactions accurately and efficiently. Key Responsibilities Provide data analysis, transactional support, error detection, resolution, and ongoing support for EDI operations Perform analysis and validation of Medicaid 8001 transaction files Review and resolve data issues related to master data, master person identifiers, and other system data discrepancies Perform system error analysis and root cause investigation Validate 1095-A and 1095-B files and reconcile 8001 transactions Analyze inbound and outbound EDI files exchanged with carriers, managed care organizations, and external partners Identify EDI file rejections, analyze root causes, and recommend corrective actions Analyze EDI 999 acknowledgment files and assist with resolving exceptions and data issues Coordinate with development, business, and testing teams to analyze, fix, test, and transmit EDI files on a daily or as-needed basis Perform data corrections to resolve consumer- or system-reported issues Access databases and applications to perform root cause analysis and implement data fixes Translate business needs into technical EDI data solutions Communicate effectively with IT teams, business users, vendors, and stakeholders Support flexible work schedules, including off-hours, weekends, and holidays as required Requirements Minimum Qualifications Bachelor’s degree in Computer Science, Information Systems, Engineering, Business, or a related field Minimum 4 years of experience working with healthcare marketplace or eligibility-based EDI solutions Minimum 4 years of experience creating and processing EDI X12 transaction sets such as 834, 999, and TA1 Minimum 4 years of experience reviewing and interpreting EDI companion guides and implementation guides Minimum 4 years of experience analyzing, testing, and providing data solutions for healthcare or eligibility systems Minimum 2 years of experience working with SQL databases and writing SQL queries Strong analytical and problem-solving skills Excellent communication skills with the ability to translate technical concepts for business users Ability to manage multiple priorities and meet tight deadlines Preferred Qualifications 6+ years of experience using EDI validation tools such as Edifecs, WTX, or equivalent 6+ years of experience working with EDI transaction sets including 834, 820, 999, and TA1 Hands-on experience writing complex SQL scripts Knowledge of Affordable Care Act (ACA) eligibility rules for Medicaid and Qualified Health Plans Experience with or knowledge of Medicaid 8001 file processing or other inter-agency transactional file processing In-depth understanding of EDI 834 enrollment transactions, including adds, changes, terminations, cancellations, and error processing

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Responsibilities

The role focuses on providing EDI data analysis, transaction support, and error resolution for large-scale healthcare and eligibility systems. It involves validating transaction files, performing root cause investigations, and coordinating with technical teams to ensure accurate data transmission.